Andorra

General************************************This small country is situated between France and Spain. Because of its elevation and proximity to the Pyrenees the climate is generally pleasant throughout the year. Climate**************
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*********************During the summer months the temperatures can rise to 30c but there is usually a cooling breeze. Lightening storms can occur during the summer months associated with torrential rain. Sun Exposure and Dehydration***************************************Those from Northern Europe can develop significant sun exposure and so remember to use a wide brimmed hat when necessary. The altitude can also lead to significant tiredness and dehydration so take sufficient initial rest and drink plenty of fluids. Safety & Security************************************The level of crime throughout the country directed at tourists is very low. Nevertheless take care of your personal belongings at all times and use hotel safety boxes where possible. Local Customs************************************There are strict laws regarding the use of illegal drugs. Make sure you have sufficient supplies of any medication you required for your trip and that it is clearly marked. The European E111 form is not accepted in Andorra and so it is essential that you have sufficient travel insurance for your trip. Winter Sports************************************Andorra is one of the regions where many travel to partake of their winter sport facilities. Generally this is well controlled and one of the safer regions. Nevertheless, make certain your travel insurance is adequate for the activities you are planning to undertake. Vaccination************************************The only standard vaccine to consider for Andorra would be tetanus in line with many other developed countries of the world.

Government in Andorra vows to kick habit of cigarette advertising
Pollution Andorra
- 2 years ago

Date: Thu, 12 Jul 2018 15:24:06 +0200

Andorra la Vella, Andorra, July 12, 2018 (AFP) - The tax haven of Andorra has long been a favourite destination for smokers looking to stock up on cheap cigarettes, but the enclave said Thursday that it would soon stop advertising the fact. The government said it had signed up to the World Health Organization's (WHO) anti-tobacco convention, which aims to encourage people to quit smoking and combat contraband sales. "The goal is to contribute to public health and pursue the fight against trafficking," government spokesman Jordi Cinca said at a press conference.

The tiny principality of Andorra, perched in the Pyrenees on the border between France and Spain, attracts millions of shoppers each year to duty-free stores, where prices of alcohol, cigarettes, electronics and clothes can be up to 20 percent cheaper than elsewhere in the EU. High taxes on tobacco imposed by many countries to help people kick smoking make Andorra's cigarettes a particularly good deal. The average pack costs just three euros ($3.50) compared with eight euros in France, which has said it will gradually raise the price to 10 euros a pack by November 2020.

Tobacco sales bring in some 110 million euros a year for Andorra, whose economy is otherwise based almost entirely on tourism. It is also an enticing destination for smugglers, with French and Spanish border agents regularly seizing cartons from people trying to sneak them out, either by car or by hiking down the mountain trails which criss-cross the Pyrenees. No date has been set for the advertising ban, which will come into effect three months after the ratification of the WHO accord is voted by parliament.

Population in Andorra witness first strike since 1933
Strikes Andorra
- 2 years ago

Date: Fri, 16 Mar 2018 02:41:51 +0100

Andorra la Vella, Andorra, March 16, 2018 (AFP) - The tiny principality of Andorra is witnessing a once in a generation phenomenon -- a widespread strike. Around a third of civil servants across the mountainous micro-state have walked out to protest proposed reforms to their sector in what has been described as Andorra's first large-scale strike since 1933.

With no negotiation breakthrough in sight, picket lines are expected to be manned again on Friday with customs officers, police, teachers and prison staff among those taking part. The first major strike in 85 years was sparked by plans from the government of Antoni Marti to reform civil servant contracts. He has assured officials "will not do an hour more" work under the reforms and that 49 million euros would be allocated for the next 25 years to supplement civil servant salaries. But government workers are unconvinced with unions warning the reforms could risk their 35 hour working week and pay.

Customs officers involved in the strike interrupted traffic on the Andorran-Spanish border this week, according to unions, while some 80 percent of teachers have walked out of classes. Strikers have occupied the government's main administrative building and held noisy protests outside parliament calling for Marti's resignation. "We have started collecting signatures to demand the resignation of the head of government and now nobody will stop us," Gabriel Ubach, spokesman for the public service union, told reporters.

Report on 2016 outbreak of Norovirus in Catalonia (Spain) linked to water from Andorra
Disease Norovirus Andorra
- 3 years ago

A recent Dispatch article published in the Centers for Disease Control and Prevention (CDC)'s Emerging Infectious Diseases journal, offers insight into a large norovirus outbreak that sprung up in Spain in 2016 that had been linked with bottled spring water. The Public Health Agency of Catalonia (ASPCAT) reported a staggering 4136 cases of gastroenteritis from 11-25 Apr 2016. Of the 4136 cases, 6 individuals required hospitalization. The CDC defines a "case-patient" as an "exposed person who had vomiting or diarrhoea (3 or more loose stools within 24 hours)," as well as 2 or more of the following symptoms: nausea, stomach pain, or fever.

ASPCAT investigators traced back the outbreak to contaminated bottled spring water in office water coolers. The water came from a source in Andorra, a small independent principality located between Spain and France. Norovirus is a "very contagious virus," according to the CDC, and it is common for individuals to become infected by eating contaminated food. Although it is possible to be infected by consuming contaminated drinking water, this mode of transmission is "rare in developed countries," according to the article.

The investigators collected water samples from a total of 4 19-L water coolers in 2 different offices located in Barcelona, "from which affected persons had drunk; samples 1 and 2 came from 2 water coolers in one office, while samples 3 and 4 came from 2 water coolers in another office. Using "positively charged glass wool and polyethylene glycol precipitation for virus concentration," the investigators tested the samples.

"We detected high RNA levels for norovirus genotype I and II, around 103 and 104 genome copies/L, in 2 of the 4 water cooler samples concentrated by glass wool filtration and polyethylene glycol precipitation," according to the article. The investigators noted that a drawback of using molecular methods is that they are not able to differentiate between particles that are infectious and those that are not. Therefore, they "predicted the infectivity of norovirus in the concentrated samples by treating the samples with the nucleic acid intercalating dye PMA propidium monoazide and Triton X surfactant before RT-qPCR," which allowed them to "distinguish between virions with intact and altered capsids."

In those 2 water samples, they found high genome copy values -- 49 and 327 genome copies/L for norovirus genotype I and 33 and 660 genomes copies/L for norovirus genotype II. This was not an unexpected finding, due to the large number of infected individuals associated with the outbreak. Through "PMA/Triton treatment before RT-qPCR assays," the investigators found that the proportion of infected virions accounted for 0.3% to 5.6% of the total number of physical particles in the water samples, "which was enough to cause gastrointestinal illness."

The investigators also analyzed faecal samples collected from infected individuals who worked at the office in which the 1st 2 water samples were collected. They detected the following genotypes in those faecal samples: GI.2 and GII.17. In the faecal samples collected from the other office, they isolated the following genotypes: GII.4/Sydney/2012, GI.2, GII.17, and GII.2.

"We hypothesize that the spring water was contaminated by all 4 strains (GI.2, GII.2, GII.4, and GII.17) but levels of viral contamination for each genotype were not homogeneous in all bottled coolers," the investigators wrote. "We may have detected only the GII.4 genotype in water samples 1 and 2 because of a higher concentration of this specific genotype or because of bias caused by the sampling, concentration, and molecular detection procedures."

The investigators admit one limitation to their study: the small number of water samples collected and analyzed. They attribute this to the fact that on 15 Apr 2016, 4 days after the onset of the outbreak, the company that produced the drinking water recalled over 6150 containers of water "of suspected quality" as a precautionary measure. The recall prevented the investigators from collecting more samples to assess, according to the article.

Although the exact cause of the contamination has not yet been identified, the investigators posit that "the high number of affected persons from 381 offices that received water coolers, and the many different genotypes found in some patients' faecal specimens" suggest that the spring aquifer had been contaminated by "sewage pollution," and the Andorra Ministry of Health and Welfare banned further use of the spring.

The investigators suggest that assessing commercially-produced mineral waters for different harmful pathogens, such as norovirus would be beneficial. They note, however, that creating, enhancing, and managing such "virus surveillance systems" would be costly. Thus, the investigators suggest taking a "balanced approach to keep both the cost and the time required for the analyses within feasibility limits." [Byline: Kristi Rosa]

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[The interesting article published in the September 2017 issue of Emerging Infectious Diseases is:

ANDORRA LA VELLA, Andorra, Dec 26, 2013 (AFP) - A Spanish skier and a French snowboarder have died in avalanches in different mountain ranges in Europe, officials said Thursday.

The 27-year-old skier, a woman from Barcelona, died Wednesday while going off-piste alone in the Soldeu resort in Andorra, in the Pyrenees mountains between France and Spain, a resort manager told AFP. Although she was rescued within 10 minutes, after her glove was spotted on the surface, she was unable to be revived despite a helicopter dash to hospital.

In the Italian Alps, close to the border with France, a 24-year-old Frenchman who was snowboarding with three friends on a closed run died Thursday when an avalanche swept over him in the resort town of Les Arnauds. Local officials said he succumbed to multiple injuries, asphyxia and hypothermia.

Avalanches are common in Europe's ski resorts at this time of year, when early snows are heavy with moisture, and several deaths occur each winter. Last Sunday, a 35-year-old Frenchman died in an avalanche in the Alps near the Italian border while on a three-day trek with a friend.

Date: Fri 7 Feb 2003 From: Jaime R. Torres Source: EFE Salud, Thu 6 Feb 2003 (translated by Maria Jacobs) [edited] -------------------------------------------------- Close to 300 students in one school and 173 tourists staying in 7 hotels in the Principality of Andorra have been affected by outbreaks of gastroenteritis that, according to local authorities, are not related to each other. Monica Codina, Minister of Health, stated that the outbreak that has affected almost 300 children and 8 adults in the San Ermengol school was detected last Monday [3 Feb 2003] but that it may have started Wednesday or Thursday of the previous week. The epidemiological surveys of a group of pre-school and grammar school students that may also be affected have not been performed yet. Also pending are the results of the microbiological tests of the food and water served in the school dining room, but the minister has indicated that the probable cause of the outbreak is the fact that water pitchers were filled with hoses directly from the faucet. The Minister stated that this outbreak of gastroenteritis is not related to the one that affected 173 tourists, most of them young people on holiday, who where staying in 7 hotels of the Principality. The government is also investigating the cause of this outbreak and has indicated that an anomaly in the system that supplies water to the hotels was detected, requiring a process of chlorination, which has not been carried out due to the heavy snowfall of the past few days. * * * * * * * * * * [The suspicion that defective water supplies may be responsible for all of these independent outbreaks suggests that the etiologic agent may be an enterovirus, hepatitis A virus, or non-viral, rather than one of the noroviruses associated with sudden-onset viral gastroenteritis. Information on the outcome of diagnostic tests in progress would be welcomed. - ProMed Mod.CP]

San Juan, March 15, 2020 (AFP) - The US territory of Puerto Rico on Sunday ordered a 9:00 pm to 5:00 am curfew to stem the spread of the novel coronavirus, the strongest measure yet taken on American soil. It took effect immediately and lasts until March 30. "Faced with the possibility of transmission and propagation of the virus, I have ordered the imposition of a curfew for all residents of Puerto Rico," Governor Wanda Vazquez announced in a video message. "We must take every precaution to ensure that we do not become potential carriers," Vazquez said.

The Caribbean territory of 2.9 million, whose residents are US citizens, also will close many businesses from Sunday until the end of the month, she said. That includes malls, movie theaters, concert venues, gyms, bars and other businesses that bring together large crowds on the island popular with tourists. The exceptions will be businesses in the food supply chain, and in the medical care system, as well as drugstores, gas stations, banks and senior citizens' group homes.

At night, only those who are providing or receiving medical care, or carrying out essential duties, will be allowed to be on Puerto Rico's streets. Anyone defying the curfew faces a six-month jail term and a fine of up to $5,000. The island declared a state of emergency when its first cases were reported March 12. The island has reported five cases. On Friday, Vazquez accepted the resignation of Health Secretary Rafael Rodriguez Mercado, who was under fire for his handling the coronavirus emergency.

Recently, island residents were irate when two warehouses were found to be filled with abandoned supplies, apparently never used after Hurricanes Irma and Maria in 2017. The storms' one-two punch left Puerto Ricans without power for months and killed nearly 3,000 people, according to the local government's official numbers. President Donald Trump has accused the Puerto Rican government of incompetence and siphoning off hurricane relief money. The Puerto Rican leaders accused Trump of treating the population of the island like second class citizens.

Yauco, Puerto Rico, Jan 16, 2020 (AFP) - Living out in the open, their nerves on edge after a series of earthquakes that have shaken Puerto Rico, some 5,000 people are hoping that their president, Donald Trump, will heed the island's plea to be designated a disaster zone and free up much-needed aid. Since December 28, more than 1,000 tremors have rattled the US island territory in the Caribbean, which just two years ago was devastated by two powerful hurricanes in quick succession.

In Yauco, one of the areas worst hit by the earthquakes, dozens of people were sitting on cot beds Wednesday in the parking lot of a municipal stadium, sheltered from the sun by white tents and blue tarps handed out by the federal disaster management agency, known as FEMA. "The most difficult thing is the psychological aspect," said Wilfredo Rodriguez, 31. His house had been fractured by the seismic movement and he has spent a week living with his kids, aged six and 10, under an awning. "We are living in constant fear of another powerful tremor," he said.

He only returns to his house to wash, then hurries back to the shelter. "We worry that there'll be a more powerful tremor while we are inside the house," he said. Throughout the day, volunteers arrive to hand out food and toys for the children who fill the shelters: schools have been suspended because the buildings are not sturdy enough to withstand another quake. The island's earthquake detection system has registered 1,104 tremors in the past two weeks alone, of which 186 could be felt by the population. By comparison, during the whole of 2019 there were 6,442 tremors, of which just 62 could be felt by people on the island.

Further south, in Guanico, Juan Santiago decided to move into a shelter on Saturday after a tremor of 5.9 on the Richter scale hit the island. "The mountain shook and rocks and earth started to come down," said the 30-year-old. "My house has a crack in it and is about to fall down," he added. His home had weathered the Category Five winds of Hurricane Maria in September 2017 and of Hurricane Irma which followed it just two weeks later. "It's different to a hurricane. What is happening now is much nastier," he said.

As he was talking the earth shook again, a tremor of 5.2 magnitude. Vehicles rocked like hammocks in the wind, but the quake-hardened victims barely reacted. The houses in this part of the island are mostly rudimentary constructions built by the people who live in them with scant resources available in the mountains, where no regulations stipulate that buildings should be earthquake resistant. The government of Puerto Rico said that as of Monday, there were 4,924 people living in 28 shelters in 14 municipalities. There were no figures on how many buildings had been damaged or destroyed.

- Seeking disaster designation -Puerto Rico's governor Wanda Vazquez Garced called on Trump to declare the earthquake a disaster and clear the way for desperately needed aid. Trump had declared an emergency days before, but the governor wanted more. The declaration of an emergency frees up to $5 million dollars in aid for the island, although Congress can bump that figure up. But if the situation is designated a disaster, there is no ceiling on funding, a FEMA spokesman said. On Wednesday, the government said it would release $8.2 billion in delayed hurricane relief that had been stalled after the president threatened to divert Puerto Rico's emergency funds to help pay for his wall on the US-Mexico border.

In the past few days there have been growing calls among Democratic lawmakers for Trump to declare the situation in Puerto Rico a disaster. It is a delicate subject, as Trump has accused the government of Puerto Rico of incompetence and of siphoning off hurricane relief money, triggering a public spat between the president and the mayor of San Juan, Carmen Yulin Cruz, as well as the former governor Ricardo Rossello, who was forced to step down last summer amid massive protests. The Puerto Rican leaders accused Trump of treating the population of the island like second class citizens.

Washington, Jan 11, 2020 (AFP) - A 5.9 magnitude earthquake rocked Puerto Rico Saturday, the latest in a series of powerful tremors that have shaken the US territory in recent days, the US Geological Survey reported.

The latest quake occurred at 8:54 am local time (1254 GMT) around 13 kilometres (eight miles) southeast of Guanica, a town on the island's southern Caribbean coastline that was hard hit by earlier quakes. The USGS revised its initial report of a 6.0 magnitude quake to 5.9. It follows a 6.4 magnitude quake Tuesday that killed one person, knocked

out electric power and caused widespread damage.

Puerto Rico Governor Wanda Vazquez declared a state of emergency after Tuesday's quake, which forced an automatic shutdown of the power grid. Puerto Rico's electric power authority reported outages in the towns of Ponce, Lares, Adjuntas and San German after the latest quake. The Pacific Tsunami Information Center in Hawaii issued a statement saying there was "no significant tsunami threat" but a small possibility of tsunami waves along coasts nearest the epicentre.

The island is still recovering from Hurricane Maria, which came ashore more than two years ago as a devastating Category 4 storm. Starting December 28, a wave of tremors have swept the island, putting residents on edge. The 6.4 quake on January 7 came a day after a 5.8 magnitude quake; it was followed by major aftershocks. Saturday's quakes were also preceded by a string of smaller tremors.

Guayanilla, Puerto Rico, Jan 7, 2020 (AFP) - Puerto Rico's governor declared a state of emergency on Tuesday after a powerful 6.4 magnitude earthquake killed at least one person in the south of the island and caused widespread damage. Governor Wanda Vazquez said the declaration would allow for the activation of National Guard troops in the US territory still recovering from a devastating 2017 hurricane. The US Geological Survey said the quake struck at 4:24 am (0824 GMT) with the epicenter off the coast of the southern city of Ponce, and was followed by more than a dozen aftershocks.

Tuesday's quake was the most powerful in a series of tremors that have shaken the island since December 28. Scientists initially sent out an alert about a potential tsunami but it was later canceled. The island's electricity authority said the quake had forced an automatic shutdown of the power grid, already severely damaged by Hurricane Maria more than two years ago. The worst damage appeared to be in towns on the southwest coast, including Ponce, Guayanilla and Guanica. El Nuevo Dia newspaper said a 73-year-old man died after a wall fell in his home in Ponce. Eight others there were reported injured.

Two power plants in Guayanilla sustained major damage, the Puerto Rico Electric Power Authority said. The city could be without power for two weeks, its mayor Nelson Torres Yordan said. Celebrity chef Jose Andres announced that a charity he runs, World Central Kitchen, had started serving meals and distributing solar-powered lamps in quake-hit areas. Vazquez announced that $130 million in emergency aid funding will be disbursed. On social media, people wrote of being shaken awake by the force of the quake. One woman on Twitter said she had been "wrenched from sleep." "Everybody is awake & scared all over," she posted. In Guayanilla, the Inmaculada Concepcion church, built in 1841, was heavily damaged. Volunteers salvaged statues and other valuable items from the ruins as a priest consoled distraught parishioners.

- 'Be safe' -A 5.8 magnitude quake on Monday toppled some structures, caused power outages and small landslides, but did not result in any casualties. It also destroyed a popular tourist landmark, Punta Ventana, a natural stone arch that crumbled on the island's southern coast. Vazquez, the governor, said government employees were being given the day off on Tuesday to take care of their families. "We want everyone to be safe," she said. She said ports were undamaged and there are several weeks' supply of gasoline, diesel and natural gas stored so people need not worry about shortages.

The White House said President Donald Trump had been briefed and Pete Gaynor, head of the Federal Emergency Management Agency (FEMA), had been in touch with the governor. Trump's administration came under severe criticism for its response to Hurricane Maria. The Category 4 storm destroyed the island's already shaky power grid, overwhelmed public services, left many residents homeless and claimed several thousand lives, according to government estimates.

Washington, Jan 7, 2020 (AFP) - A strong earthquake struck south of Puerto Rico early Tuesday, the US Geological Survey said, the latest in a series of tremors that have shaken the island since December 28. The shallow 6.5 magnitude quake struck 13.6 kilometres (8.5 miles) south of the city of Ponce, the USGS said, revising down its initial reading of 6.6. The quake struck just off the US territory's southern Caribbean coastline at 4:24 am local time (0824 GMT). "The whole island is without power," the director of Puerto Rico Electric Power Authority, Jose Ortiz, told local media.

Puerto Rico's governor Wanda Vazquez Garced posted on Twitter that the government's security protocols had been activated. She said government employees were not expected at work, adding: "We want everyone to be safe." On social media, people wrote of being shaken awake by the force of the quake. One woman on Twitter said she had been "wrenched from sleep", adding "Everybody is awake & scared all over."

Dramatic images also shared on social media appeared to show widespread damage in the town of Guayanilla, home to around 20,000 people, as well as nearby Guanica. The mayor of Guayanilla told local news channel NotiUno that the town's church had collapsed in the incident.

An alert issued by the Tsunami Warning Center immediately following the earthquake was later cancelled. Tuesday's quake was the strongest of a series of tremors that have shaken the island since December 28, topping Monday's 5.8 quake. That earthquake toppled houses and caused power outages, but there were no reports of casualties.

Gibraltar

United Kingdom and Gibraltar (England, Wales, Scotland, Northern Ireland) US Consular Information SheetJune 03, 2008 COUNTRY DESCRIPTION:The United Kingdom of Great Britain and Northern Ireland is a highly developed constitutional monarc
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y comprised of Great Britain (England, Scotland and Wales) and Northern Ireland.Read the Department of State Background Notes on the United Kingdom for additional information.Gibraltar is a United Kingdom Overseas Territory bordering Spain and located at the southernmost tip of Europe at the entrance to the Mediterranean Sea.It is one of thirteen former British colonies that have elected to continue their political links with London.Tourist facilities are widely available.

ENTRY/EXIT REQUIREMENTS:A visa is not required for tourist or business visits to the UK of less than six months in duration.Visitors wishing to remain longer than one month in Gibraltar should regularize their stay with Gibraltar immigration authorities.Those planning to visit the UK for any purpose other than tourism or business, or who intend to stay longer than six months, should consult the website of the British Embassy in the United States at http://britainusa.com for information about current visa requirements.Those who are required to obtain a visa and fail to do so may be denied entry and returned to their port of origin.The British government is currently considering reducing the visa-free period from six months to 90 days.Travelers should be alert to any changes in legislation.The U.S. Embassy cannot intervene in UK visa matters. In addition to the British Embassy web site at http://britainusa.com, those seeking current UK visa information may also contact UK consular offices via their premium rate telephone service at 1-900-656-5000 (cost $3/minute) or 1-212-796-5773 ($12 flat fee). Information about dual nationality or the prevention of international child abduction can be found on our web site.For further information about customs regulations, please read our Customs Information sheet. SAFETY AND SECURITY:The United Kingdom is politically stable, with a modern infrastructure, but shares with the rest of the world an increased threat of terrorist incidents of international origin, as well as the potential, though significantly diminished in recent years, for isolated violence related to the political situation in Northern Ireland (a part of the United Kingdom). On July 7, 2005, a major terrorist attack occurred in London, as Islamic extremists detonated explosives on three underground trains and a bus in Central London, resulting in over 50 deaths and hundreds of injuries.Following the attacks, the public transportation system was temporarily disrupted, but quickly returned to normal.A similar but unsuccessful attack against London’s public transport system took place on July 21, 2005.UK authorities have identified and arrested people involved in these attacks.Similarly, those involved in terrorist incidents in London and Glasgow during the summer of 2007 were identified and arrested. Like the US, the UK shares its national threat levels with the general public to keep everyone informed and explain the context for the various increased security measures that may be encountered. UK threat levels are determined by the UK Home Office and are posted on its web site at http://www.homeoffice.gov.uk/security/current-threat-level/.Information from the UK Security Service, commonly known as MI5, about the reasons for the increased threat level and actions the public can take is available on the MI5 web site at http://www.mi5.gov.uk/.On August 10, 2006, the Government of the United Kingdom heightened security at all UK airports following a major counterterrorism operation in which individuals were arrested for plotting attacks against US-bound airlines.As a result of this, increased restrictions concerning carry-on luggage were put in place and are strictly enforced.American citizens are advised to check with the UK Department for Transport at http://www.dft.gov.uk/transportforyou/airtravel/airportsecurity/ regarding the latest security updates and carry-on luggage restrictions. The British Home Secretary has urged UK citizens to be alert and vigilant by, for example, keeping an eye out for suspect packages or people acting suspiciously at subway (called the “Tube” or Underground) and train stations and airports and reporting anything suspicious to the appropriate authorities.Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.For more information about UK public safety initiatives, consult the UK Civil Contingencies Secretariat web site at http://www.ukresilience.gov.uk. The political situation in Northern Ireland has dramatically improved since the signing of the Good Friday Agreement in 1998, the announcement by the Irish Republican Army (IRA) on July 28, 2005, that it would end its armed campaign, and the agreement to set up a power-sharing government on May 8, 2007.The potential remains, however, for sporadic incidents of street violence and/or sectarian confrontation. American citizens traveling to Northern Ireland should therefore remain alert to their surroundings and should be aware that if they choose to visit potential flashpoints or attend parades sporadic violence remains a possibility. Tensions may be heightened during the summer marching season (April to August), particularly during the month of July around the July 12th public holiday.

The phone number for police/fire/ambulance emergency services - the equivalent of "911" in the U.S. - is “999” in the United Kingdom and “112” in Gibraltar.This number should also be used for warnings about possible bombs or other immediate threats.The UK Anti-Terrorist Hotline, at 0800 789 321, is for tip-offs and confidential information about possible terrorist activity. For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings, Travel Alerts, as well as the Worldwide Caution can be found.Recent communications from U.S. Embassy London to the local American citizen community, called Warden Messages, can be found on the U.S. Embassy's American Citizens' Services web site at http://london.usembassy.gov/cons_new/acs/index.html. Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays). The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet, A Safe Trip Abroad. CRIME:The United Kingdom and Gibraltar benefit from generally low crime rates and rates decreased slightly in 2007 in significant categories, including violent crime.The crime situation in the UK is similar to the United States, with typical incidents including pick-pocketing; mugging; “snatch and grab” thefts of mobile phones, watches and jewelry; and theft of unattended bags, especially at airports and from cars parked at restaurants, hotels and resorts.Pickpockets target tourists, especially at historic sites, restaurants, on buses, trains and the London Underground (the “Tube,” or subway).Thieves often target unattended cars parked at tourist sites and roadside restaurants, looking for laptop computers and hand-held electronic equipment, especially global positioning satellite equipment.Walking in isolated areas, including public parks, especially after dark, should also be avoided, as these provide advantageous venues for muggers and thieves.At night or when there is little foot traffic, travelers should be especially careful using the underground pedestrian tunnels.As a general rule, either walk the extra distance to use a surface crossing or wait until there are other adult pedestrians entering the tunnel.

In London, travelers should use only licensed “black taxi cabs,” or car services recommended by their hotel or tour operator.Unlicensed taxis or private cars posing as taxis may offer low fares, but are often uninsured and may have unlicensed drivers.In some instances, travelers have been robbed and raped while using these cars.You can access 7,000 licensed “Black Cabs” using just one telephone number – 0871 871 8710. This taxi booking service combines all six of London’s radio taxi circuits, allowing you to telephone 24 hours a day if you need to “hail a cab.” Alternatively, to find a licensed minicab, text “HOME” to 60835 on your mobile phone to get the telephone number to two licensed minicab companies in the area. If you know in advance what time you will be leaving for home, you can pre-book your return journey.The “Safe Travel at Night” partnership among the Metropolitan Police, Transport for London, and the Mayor of London maintains a website with additional information at http://www.cabwise.com/. Travelers should not leave drinks unattended in bars and nightclubs.There have been some instances of drinks being spiked with illegal substances, leading to incidents of robbery and rape. Due to the circumstances described above, visitors should take steps to ensure the safety of their U.S. passports.Visitors in England, Scotland, Wales, Northern Ireland, and Gibraltar are not expected to produce identity documents for police authorities and thus may secure their passports in hotel safes or residences.Abundant ATMs that link to U.S. banking networks offer an optimal rate of exchange and they preclude the need to carry a passport to cash travelers’ checks.Travelers should be aware that U.S. banks might charge a higher processing fee for withdrawals made overseas.Common sense personal security measures utilized in the U.S. when using ATMs should also be followed in the UK.ATM fraud in the UK is becoming more sophisticated, incorporating technologies to surreptitiously record customer ATM card and PIN information.Travelers should avoid using ATMs that look in any way “temporary” in structure or location, or that are located in isolated areas.Travelers should be aware that in busy public areas, thieves use distraction techniques, such as waiting until the PIN number has been entered and then pointing to money on the ground, or attempting to hand out a free newspaper.When the ATM user is distracted, a colleague will quickly withdraw cash and leave.If distracted in any way, travelers should press the cancel transaction button immediately and collect their card before speaking to the person who has distracted them.If the person’s motives appear suspicious, travelers should not challenge them but remember the details and report the matter to Police as soon as possible.In addition, travelers should not use the ATM if there is anything stuck to the machine or if it looks unusual in any way.If the machine does not return the card, report the incident to the issuing bank immediately.

INFORMATION FOR VICTIMS OF CRIME:The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate at the opening of the next business day.The U.S. Embassy or Consulate only issues replacement passports during regular business hours.If you are the victim of a crime while overseas, report it to local police.The nearest U.S. Embassy or Consulate will also be able to assist by helping you to find appropriate medical care, contacting family members or friends, and explaining how funds could be transferred.Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

Visit the “Victim Support” web site, maintained by an independent UK charity to helps people cope with the effects of crime: http://www.victimsupport.org.uk/See our information for Victims of Crime. MEDICAL FACILITIES AND HEALTH INFORMATION:While medical services are widely available, free care under the National Health System is allowed only to UK residents and certain EU nationals.Tourists and short-term visitors will be charged for medical treatment in the UK.Charges may be significantly higher than those assessed in the United States. Hiking in higher elevations can be treacherous.Several people die each year while hiking, particularly in Scotland, often due to sudden changes in weather.Visitors, including experienced hikers, are encouraged to discuss intended routes with local residents familiar with the area, and to adhere closely to recommendations. Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.

MEDICAL INSURANCE:The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.If your medical insurance policy does not provide overseas coverage, you may want to purchase a short-term policy for your trip.The Department of State provides a list of travel insurance companies that can provide the additional insurance needed for the duration of one’s trip abroad in its online at medical insurance overseas. Remember also that most medical care facilities and medical care providers in the UK do not accept insurance subscription as a primary source of payment.Rather, the beneficiary is expected to pay for the service and then seek reimbursement from the insurance company.This may require an upfront payment in the $10,000 to $20,000 range

Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.The information below concerning the United Kingdom is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

UK penalties for driving under the influence of even minimal amounts of alcohol or drugs are stiff and often result in prison sentences.In contrast to the United States and continental Europe, where traffic drives on the right side of the road, in the UK, it moves on the left. The maximum speed limit on highways/motorways in the UK is 70MPH.Motorways generally have a hard shoulder (breakdown lane) on the far left, defined by a solid white line.It is illegal to stop or park on a hard shoulder unless it is an emergency.In such cases, you should activate your hazard lights, get out of your vehicle and go onto an embankment for safety. Emergency call boxes (orange telephone booths with “SOS” printed on them) may be found at half-mile intervals along the motorway.White and blue poles placed every 100 yards along the motorway point in the direction of the nearest call box.Emergency call boxes dial directly to a motorway center.It is best to use these phones rather than a personal cell phone, because motorway center personnel will immediately know the location of a call received from an emergency call box. Roadside towing services may cost approximately £125.However, membership fees of automotive associations such as the RAC or AA (Automobile Association) often include free roadside towing service.Visitors uncomfortable with, or intimidated by, the prospect of driving on the left-hand side of the road may wish to avail themselves of extensive bus, rail and air transport networks that are comparatively inexpensive.Roads in the UK are generally excellent, but are narrow and often congested in urban areas.If you plan to drive while in the UK, you may wish to obtain a copy of the Highway Code, available at http://www.highwaycode.gov.uk. Travelers intending to rent cars in the UK should make sure that they are adequately insured.U.S. auto insurance is not always valid outside the U.S., and travelers may wish to purchase supplemental insurance, which is generally available from most major rental agents.The city of London imposes a congestion charge of £8 (eight pounds sterling, or approximately U.S. $16.00) on all cars entering much of central London Monday through Friday from 7:00 a.m. to 6:30 p.m.Information on the congestion charge can be found at http://www.cclondon.com. Public transport in the United Kingdom is excellent and extensive.However, poor track conditions may have contributed to train derailments resulting in some fatalities.Repairs are underway and the overall safety record is excellent.Information on disruptions to London transportation services can be found at http://www.tfl.gov.uk and information about the status of National Rail Services can be found at http://www.nationalrail.co.uk.Many U.S. pedestrians are injured, some fatally, every year in the United Kingdom, because they forget that oncoming traffic approaches from the opposite direction than in the United States.Extra care and alertness should be taken when crossing streets; remember to look both ways before stepping into the street. Driving in Gibraltar is on the right-hand side of the road, as in the U.S. and Continental Europe.Persons traveling overland between Gibraltar and Spain may experience long delays in clearing Spanish border controls. Please refer to our Road Safety Overseas page for more information.For specific information concerning United Kingdom driving permits, vehicle inspection, road tax and mandatory insurance, refer to the United Kingdom’s Department of Environment and Transport web site at http://www.dft.gov.uk, the Driving Standards Agency web site at http://www.dsa.gov.uk or consult the U.S. Embassy in London’s web site at http://london.usembassy.gov/.

AVIATION SAFETY OVERSIGHT:The U.S. Federal Aviation Administration (FAA) has assessed the Government of the United Kingdom’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the UK’s air carrier operations.For further information, travelers may visit the FAA's web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:The legal drinking age in the UK is generally lower than in the U.S. and social drinking in pubs is often seen as a routine aspect of life in Britain. Parents, organizers of school trips, and young travelers should be aware of the impact that this environment may have when combined with the sense of adventure that comes with being abroad.Please see our Students Abroad web site as well Studying Abroad to help students plan a safe and enjoyable adventure. The UK has strict gun-control laws, and importing firearms is extremely complicated. Travelers should consider leaving all firearms in the United States.Restrictions exist on the type and number of weapons that may be possessed by an individual.All handguns, i.e. pistols and revolvers, are prohibited with very few exceptions.Licensing of firearms in the UK is controlled by the Police.Applicants for a license must be prepared to show 'good reason' why they require each weapon.Applicants must also provide a copy of their U.S. gun license, a letter of good conduct from their local U.S. police station and a letter detailing any previous training, hunting or shooting experience. Background checks will also be carried out.Additional information on applying for a firearm certificate and/or shotgun certificate can be found on the Metropolitan Police Firearms Enquiry Teams web site at http://www.met.police.uk/firearms-enquiries/index.htm. A number of Americans are lured to the UK each year in the belief that they have won a lottery or have inherited from the estate from a long-lost relative.Americans may also be contacted by persons they have “met” over the Internet who now need funds urgently to pay for hospital treatment, hotel bills, taxes or airline security fees.Invariably, the person contacted is the victim of fraud.Any unsolicited invitations to travel to the UK to collect winnings or an inheritance should be viewed with skepticism.Also, there are no licenses or fees required when transiting a UK airport, nor is emergency medical treatment withheld pending payment of fees.Please see our information on International Financial Scams. Please read our Customs Information.

CRIMINAL PENALTIES:While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.Penalties for breaking the law can be more severe than in the United States for similar offenses.Persons violating British law, even unknowingly, may be expelled, arrested or imprisoned.Penalties for possession, use, or trafficking in illegal drugs in the UK are severe, and convicted offenders can expect long jail sentences and heavy fines.Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.Please see our information on Criminal Penalties. Many pocketknives and other blades, and mace or pepper spray canisters, although legal in the U.S., are illegal in the UK and will result in arrest and confiscation if detected.A UK Metropolitan Police guide to items that are prohibited as offensive weapons is available at http://www.met.police.uk/youngpeople/guns.htm.A UK Customs Guide, detailing what items visitors are prohibited from bringing into the UK, is available at http://customs.hmrc.gov.uk/channelsPortalWebApp/downloadFile?contentID=HMCE_CL_001734.Air travelers to and from the United Kingdom should be aware that penalties against alcohol-related and other in-flight crimes (“air rage”) are stiff and are being enforced with prison sentences.Please also see our information on customs regulations that pertain when returning to the US.

CHILDREN'S ISSUES:For information on intercountry adoption and international parental child abduction, see the Office of Children’s Issues.

REGISTRATION / EMBASSY LOCATION:Americans living or traveling in the United Kingdom are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, and to obtain updated information on travel and security within the United Kingdom.By registering, Americans make it easier for the Embassy or Consulate to contact them in case of emergency, and to relay updated information on travel and security within the United Kingdom.The Embassy and Consulates regularly send security and other information via email to Americans who have registered.As noted above, recent communications from U.S. Embassy London to the local American citizen community, called Warden Messages, can be found on the embassy’s web site.Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.The Consular Section also disseminates a newsletter every month.Those wishing to subscribe to the monthly consular newsletter in London should send a request by email to SCSLondon@state.gov. The U.S. Embassy is located at 24 Grosvenor Square, London W1A 1AE; telephone: in country 020-7499-9000; from the U.S. 011-44-20-7499-9000 (24 hours); Consular Section fax: in country 020-7495-5012; from the U.S. 011-44-20-7495-5012, and on the Internet at http://london.usembassy.gov. The U.S. Consulate General in Edinburgh, Scotland, is located at 3 Regent Terrace, Edinburgh EH7 5BW; Telephone: in country 0131-556-8315, from the U.S. 011-44-131-556-8315.After hours: in country 01224-857097, from the U.S. 011-44-1224-857097.Fax: in country 0131-557-6023; from the U.S. 011-44-131-557-6023.Information on the Consulate General is included on the Embassy’s web site at http://london.usembassy.gov/scotland. The U.S. Consulate General in Belfast, Northern Ireland, is located at Danesfort House, 228 Stranmillis Road, Belfast BT9 5GR; Telephone: in country 028-9038-6100; from the U.S. 011-44-28-9038-6100.Fax:in country 028-9068-1301; from the U.S. 011-44-28-9068-1301.Information on the Consulate General is included on the Embassy’s web site at: http://london.usembassy.gov/nireland. There is no U.S. consular representation in Gibraltar.Passport questions should be directed to the U.S. Embassy in Madrid, located at Serrano 75, Madrid, Spain, tel (34)(91) 587-2200, and fax (34)(91) 587-2303.The web site is http://madrid.usembassy.gov.All other inquiries should be directed to the U.S. Embassy in London.* * *This replaces the Consular Information Sheet dated December 12, 2007, to update the sections on Entry Requirements, Safety and Security, Crime, Victims of Crime, Medical Facilities, Medical Insurance, Traffic Safety and Road Conditions, and Special Circumstances.

Aedes mosquitoes in Gilbraltar lead to concern over a number of diseases
Disease Chikungunya Virus Gibraltar
- 3 years ago

An aggressive species of mosquito known to transmit viral diseases has been detected in Gibraltar, but public health officials insist there is no cause for alarm. Public Health Gibraltar and the Environmental Agency confirmed that the mosquito of the species _Aedes albopictus_, also known as the tiger mosquito, has been found in Gibraltar.

Last June [2017] after 9 months of intensive surveillance, officials said no tiger mosquito had been found in Gibraltar. But this has now changed after the 1st tiger mosquito was found in the urban dome stic environment within Gibraltar. "This finding alone does not however materially alter any health risks in Gibraltar and there is no immediate cause for public concern," the government said in a statement. Public Health Gibraltar was first alerted in January 2016 to the discovery of the mosquito in Malaga and Algeciras [in Andalusia, Spain]. Since then, together with the Environmental Agency, it began working with international experts to mount surveillance in Gibraltar.

World Health Organization experts visited Gibraltar and gave advice on setting traps and monitoring locations, but no tiger mosquito had been detected until now. The tiger mosquito is not native to Gibraltar and has not been previously found here. It is common in other countries where it transmits viral diseases like Zika, dengue, and chikungunya. It is a domestic species, breeds in water in urban areas -- water butts, blocked drains, rainwater gullies -- and is able to reach high abundance around residential areas.

It is also a day-time mosquito, that aggressively bites humans. "Health risks to the public only arise if the virus causing these diseases is also present, which is not the case in Gibraltar," the government said. "The virus can, however, be imported by travellers returning from an overseas country and if this happens, there is a risk of spread, but only if the mosquito bites within a small window period of about a week after the fever starts."

Public Health Gibraltar has been raising awareness of travel risk amongst travellers through its publication A Factsheet for Travellers and recommends the following precautions:- before travelling to affected areas, consult your doctor or seek advice from a travel clinic, especially if you have an immune disorder or severe chronic illness;- if you are pregnant or are considering pregnancy, consider postponing non-essential travel;- when staying in a mosquito-prone area, wear mosquito repellents and take mosquito bite prevention measures;- if you have symptoms within 3 weeks of return from an affected country, contact your doctor;- if you have been diagnosed with any of the diseases Zika, dengue, or chikungunya, take strict mosquito bite prevention measures for 10 days after the fever starts.========================== [The appearance of _Aedes albopictus_ in Gibraltar is not surprising. A map of the distribution of this species as of April this year (2017) shows it present around the Mediterranean Basin and up to Gibraltar on the west (<https://ecdc.europa.eu/en/publications-data/aedes-albopictus-current-known-distribution-europe-april-2017>).

Now it has been found in Gibraltar. The concerns are real about transmission of dengue, chikungunya, and Zika viruses should populations of _Ae. albopictus_ become established. In 2015 there were a few locally acquired cases of dengue in the south of France. This also happened on a larger scale in Emilia Romagna, Italy, when a viraemic man introduced chikungunya virus into Italy and sparked an outbreak.

One hopes that mosquito surveillance will continue in Gibraltar, perhaps be intensified, and help guide vector control efforts. - ProMED Mod.TY]

GIBRALTAR, June 1, 2011 (AFP) - A fuel tank exploded and caught fire near a cruise ship in the British territory of Gibraltar Tuesday, injuring at least 15 people, most of them on the vessel, local officials and the ship's owners said. The blast was probably caused by a spark from welding operations, Chief Minister Peter Caruana told Radio Gibraltar. But police were not ruling out any possibility including that of an attack, he added. Flames several metres high could be seen coming out of the tank with dense black smoke billowing across the port as firefighters directed jets of water at the blaze from tugboats. The fire continued late into the night, with Radio Gibraltar reporting more explosions were heard. The tank was close to the giant cruise ship, Independence of the Seas, which had arrived in Gibraltar Tuesday morning. The ship made an emergency departure immediately after the blast Tuesday afternoon.

The Gibraltar government and the ship's owners, Royal Caribbean International, both said 12 people on the ship had been hurt. Gibraltar officials said one of the passengers had suffered a fractured arm. Two Spanish welders working on the tank were injured, including one who was in critical condition in a burns unit at a hospital in the southern Spanish city of Seville, Radio Gibraltar said. A police officer was also slightly injured in the rescue attempt, police said. "The lid of the tank was blown off by the blast," a police spokesman said. The statement from Royal Caribbean International said: "Immediately after the explosion, the ship retracted the gangway and moved a safe distance from the dock. "Twelve guests sustained minor injuries and have received medical treatment onboard." The boat was on a two-week cruise, having left the southern English port of Southampton on Saturday, the company added.

Air services to Gibraltar were suspended and offices in the port area evacuated. The police spokesman said the possibility of adjacent tanks overheating and exploding could not be ruled out. Caruana described it as a serious incident but said there was "no cause for concern". "Once it was established that there were welding operations going on, on top of the very tank at the time it exploded, (that) makes that a frontrunner for a likely explanation, but all possibilities are being kept open," he told Radio Gibraltar. "The police are obviously keeping their minds open to the possibility of maybe a security incident. It's looking unlikely but all possibilities are being looked into if only to be excluded."

"The plan is to allow it to carry on burning itself off," he said later Tuesday, but warned that the wind was due to change during the night, which could bring the smoke over land. Spanish tugs from a private company were helping the local fire services, he added. One witness said he was in his office nearby when he heard three loud explosions. "We started running out and saw one of the main tanks set alight. My concern was the poor people who were working there," he told Radio Gibraltar. The public was being advised to keep away from the area and keep windows closed due to the smoke. Gibraltar is a 6.5-square-kilometre (2.6-square-mile) British territory of around 30,000 people off the tip of southern Spain. Madrid ceded it to London in 1713 under the Treaty of Utrecht, but it has long fuelled tensions between the two countries.

GIBRALTAR, Aug 10, 2010 (AFP) - Gibraltar on Tuesday condemned as "illegal" a proposal by the neighbouring Spanish town of La Linea to impose a tax on cars entering or leaving the tiny British territory by road. The decision comes amid thorny relations between Madrid and London over the disputed British possession off the tip of southern Spain.

La Linea mayor Alejandro Sanchez on Monday announced the "congestion charge" of no more than five euros (6.5 dollars) on cars crossing into and out of Gibraltar, saying the measure will be imposed in October once it is passed by the town council. He said lorries carrying debris and other materials used in Gibraltar to reclaim land from the sea will pay more, but the exact amount has not yet been determined. Sanchez, a member of Spain's conservative opposition Popular Party, said the tax is needed partly to compensate the municipality for austerity measures imposed by the socialist government in Madrid. La Linea residents would be exempt, but it was not clear if Gibraltarians would also have to pay.

The Gibraltar government reacted angrily and said it has contacted the Spanish authorities over the decision. "The confused statements by the mayor of La Linea in respect of the proposed toll describe a litany of illegalities under EU Law and probably also under Spanish law," it said in a statement. "The mayor of La Linea is clearly engaged in a political manoeuvre with his central government, which is unlikely to allow the proposal.

"The mayor's proposals are wholly unacceptable both legally and politically and in the unlikely event that these measures should be introduced, the (Gibraltar) government will take appropriate steps." Spain ceded Gibraltar to Britain in 1713 under the Treaty of Utrecht but has retained first claim on the tiny peninsula should Britain renounce sovereignty.

"The Rock" has long fuelled tensions between Spain and Britain, with Madrid arguing the 6.5-square-kilometre (2.6-square-mile) territory that is home to roughly 30,000 people should be returned to Spanish sovereignty. But its people overwhelmingly rejected an Anglo-Spanish proposal for co-sovereignty in a referendum in 2002. In recent months British and Spanish naval and police boats have engaged in a series of cat and mouse games in the waters off Gibraltar, which lies at the strategic western entrance to the Mediterranean.

During the last 10 weeks, Gibraltar has experienced an outbreak of measles. "We have so far been notified of over 250 cases and notifications are still coming in at around 4-6 cases per day," said the Gibraltar Health Authority [GHA], who believe that the actual numbers are greater as many people with mild attacks have chosen not to report them. While the majority of infections in the outbreak have been mild, some have been severe and a few patients including babies have needed intensive care. Measles is an unpleasant disease with fever, sore throat, streaming eyes, diarrhoea, and rash. Most people recover within a week or so, but complications like fits, bacterial infection, or pneumonia can develop. Long-term complications can also arise in very young children.

Says the GHA: It is important that all persons with symptoms suggestive of measles should report the illness to their doctor to enable complications to be detected at an early stage. In addition to medical advice, persons with the illness should follow general hygiene practices such as limiting contact with other people, carefully discarding soiled tissues, and washing their hands. Anyone who has had measles infection is immune for life and cannot get measles again. There is no basis for the rumour that some people have had measles twice. It is possible that infection with rubella (German measles, a different disease) may have caused the confusion. Vaccination with the MMR [measles, mumps, and rubella] vaccine is the only way to prevent measles infection.

[So far], the 250 cases have been in persons who are unvaccinated or partly vaccinated (one dose only). Not a single case has occurred in a person who has had a full course of MMR vaccine. MMR vaccine has been available free to children [from] Gibraltar's health service since 1989, although the boosters were only introduced in 2002. It is also a very safe and effective vaccine, with an impressive track record," they say. Gibraltar Health Authority adds that it is continuing to advise all parents of children who have not had the MMR vaccine to immunise their children. There had been some difficulties in obtaining vaccine recently due to an international shortage, but fresh supplies have now been received. The course consists of 2 injections, approximately 3 months apart. Please note that BOTH the doses are needed for adequate immunity. They add: If your child has received only one dose, either now or in the past, he or she could still be at risk. Arrangements have been made to offer additional vaccination to all unimmunised children as follows: During October and November [2008], the Child Welfare Clinics (primary care centre) will be open on Mondays (2:00 pm to 4:00 pm), Wednesdays (9:00 am to 11:00 am) and Fridays (9:00 am to 11:00 am) for immunisations. Appointments are not necessary.

-------------------------------

[The Rock of Gibraltar is located at the entrance of the Mediterranean. Gibraltar is connected to Spain by a sandy isthmus, by a ferry to Morocco, and by flights to London. By virtue of its geographical position and political status Gibraltar is vulnerable to introduction of infectious disease from diverse sources. No information has been provided regarding the source of the measles virus responsible for this outbreak. In this respect it will be relevant to determine the genotype of the measles virus involved (see comment in ProMED-mail "Measles - Gibraltar 20080814.2529"). The outbreak has escalated from the 17 cases reported on 14 Aug 2008 to the current 250 cases. Despite the availability of free MMR vaccination it is clear that there is an appreciable number of unimmunised individuals in the community who remain susceptible to measles virus infection. It is encouraging that efforts are underway to expand vaccine coverage.

Date: Wed, 16 Apr 2008 14:56:40 +0200 (METDST) GIBRALTAR, April 16, 2008 (AFP) - Animal rights groups have expressed outrage over a plan by Gibraltar's government to cull its famous Barbary Apes, which are posing a hazard as they roam the town in search of food. The government of the tiny British territory off Spain's southern coast plans to cull 25 of the simians, whose population has exploded to around 200. The mischievous primates climb over cars and pull out antennas, open rubbish bags and rifle through handbags left unattended in the popular tourist destination. Officially, the management of the apes is the responsibility of the Gibraltar Ornithological and Natural History Society (GONHS), on contract from the government. But the society said it has not approved the cull. "Our policy is that culling can be a population management solution but only in extreme cases when there is no other more suitable option," GONHS general secretary Dr. John Cortes said on Tuesday. "We would only ever recommend a cull after very careful assessment of the situation from a veterinary and a genetic point of view." However, Environment Minister Ernest Britto said a licence has been issued for the cull and two of the apes have already been given lethal injections. Helen Thirlway, the head of Britain's International Primate Protection League, said the government was failing to manage the apes "in a responsible manner." "There have been many advances and pilot studies in recent years on different methods of controlling free-roaming monkeys," she was quoted as saying in the local media Wednesday. "We are more than happy to work with the government of Gibraltar and with GONHS to help them develop more efficient, alternative solutions, but this needless slaughter has to stop." According to legend, if the apes disappear, Britain will lose control of Gibraltar. When wartime British prime minister Winston Churchill heard their population was low, British consuls in North Africa -- from where the apes originally came -- were tasked with sending new young simians to the Rock. At one time, the apes were looked after by the British army stationed in Gibraltar, which selected a place up the Rock where they were fed daily to keep them from loitering downtown. Spain ceded Gibraltar to Britain in 1713, but has retained a constitutional claim should Britain renounce sovereignty. The vast majority of the 30,000 people want to retain their links with Britain.

Venezuela

Venezuela is a medium income country whose economy is dominated by a substantial oil industry.The political climate in Venezuela is highly polarized and
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olatile.Violent crime is a continuing problem.Assaults, robberies, and kidnappings occur throughout the country.Scheduled air service and all-weather roads connect major cities and most regions of the country.Venezuela’s tourism infrastructure varies in quality according to location and price.For an in depth country description of Venezuela, please read the Department of State Background Notes on Venezuela. ENTRY/EXIT REQUIREMENTS:A valid passport and a visa or tourist card are required.Tourist cards are issued on flights from the U.S. to Venezuela for persons staying less than ninety days.Persons traveling for reasons other than tourism, however, should consult the Venezuelan Embassy or nearest Venezuelan consulate regarding possible visa requirements for their specific purpose of travel.Venezuelan immigration authorities may require that U.S. passports have at least six months validity remaining from the date of arrival in Venezuela.Some U.S. citizens have been turned back to the United States if their passports will expire in less than six months. Passports should also be in good condition, as some U.S. citizens have been delayed or detained overnight for having otherwise valid passports in poor condition. U.S. citizens residing in Venezuela should be careful to obtain legitimate Venezuelan documentation appropriate to their status.There have been numerous cases in the last several months of U.S. citizens who, having employed intermediaries, received what they believed to be valid Venezuelan resident visas and work permits.They were subsequently arrested and charged with possessing fraudulent Venezuelan documentation.ONIDEX, the Venezuelan government agency responsible for immigration documents, has informed the Embassy that the only valid resident visas are those for which the bearer has personally signed at ONIDEX headquarters in Caracas.

Venezuelan law requires Venezuelan citizens to enter and depart Venezuela using Venezuelan passports and Venezuelan immigration authorities are increasingly enforcing this requirement.In order to comply with U.S. and Venezuelan law, persons who hold dual American-Venezuelan nationality must plan to travel between Venezuela and the United States with valid U.S. and Venezuelan passports.Please see our information on dual nationality for entry and exit requirements pertaining to dual nationals. Venezuela's child protection law mandates that minors (under 18) who are citizens or non-citizen residents of Venezuela and who are traveling alone, with only one parent, or with a third party, must present a copy of their birth certificate and written, notarized authorization from the absent parent(s) or legal guardian, specifically granting permission to travel alone, with one parent, or with a third party.This authorization must reflect the precise date and time of the travel, including flight and/or other pertinent information.Without this authorization, immigration authorities will prevent the child's departure from Venezuela.The Venezuelan Government no longer recognizes blanket or non-specific travel authorizations.When a parent is deceased, a notarized copy of the death certificate is required in lieu of the written authorization.If documents are prepared in the United States, the authorization and the birth certificate must be translated into Spanish, notarized, and authenticated by the Venezuela Embassy or a Venezuelan consulate in the United States.If documents are prepared in Venezuela, only notarization by a Venezuelan notary is required.A permission letter prepared outside Venezuela is valid for 90 days.A permission letter prepared in Venezuela is valid for 60 days. Travelers entering Venezuela from certain countries are required to have a current yellow fever vaccination certificate.The Venezuelan government recommends that all travelers, regardless of their country of departure, be vaccinated for yellow fever before entering Venezuela.Mosquito-borne diseases such as malaria and dengue fever are also common in some areas and travelers should take precautions to prevent infection.

An exit tax and airport fee must be paid when departing Venezuela by airline.The exit tax is currently 46 Bolívares Fuertes, and the airport fee is currently 115 Bolívares Fuertes (a total of approximately 75 USD calculated at the official exchange rate). In many instances, especially with non-U.S. airlines, the exit tax and airport fee are not included in the airline ticket price and must be paid separately at the airport upon departure.Authorities usually require that payment be made in local currency.Both the departure tax and the airport fee are subject to change with little notice.Travelers should check with their airlines for the latest information. For current information concerning entry, tax, and customs requirements for Venezuela, travelers may contact the Venezuelan Embassy at 1099 30th Street, NW, Washington DC20007, tel: (202) 342-2214, or visit the Embassy of Venezuela web site at http://www.embavenez-us.org/.Travelers may also contact the Venezuelan consulates in New York, Miami, Chicago, New Orleans, Boston, Houston, San Francisco, or San Juan.Additional information about vaccination requirements for travel to Venezuela, as well as to other international destinations, may be obtained from the Centers for Disease Control and Prevention's hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747); fax 1-888-CDC-FAXX (1-888-232-3299), or via CDC's Internet site at http://wwwn.cdc.gov/travel/default.aspx.

Information about dual nationality or the prevention of international child abduction can be found on our web site.For further information about customs regulations, please read our Customs Information sheet. SAFETY AND SECURITY:Violent crime in Venezuela is pervasive, both in the capital, Caracas, and in the interior.The country has one of the highest per-capita murder rates in the world.Armed robberies take place in broad daylight throughout the city, including areas generally presumed safe and frequented by tourists.A common technique is to choke the victim into unconsciousness and then rob them of all they are carrying.Well-armed criminal gangs operate with impunity, often setting up fake police checkpoints.Kidnapping is a particularly serious problem, with more than 1,000 reported during the past year alone.Investigation of all crime is haphazard and ineffective.In the case of high-profile killings, the authorities quickly round up suspects, but rarely produce evidence linking these individuals to the crime.Only a very small percentage of criminals are tried and convicted.

Travel to and from Maiquetía Airport, the international airport serving Caracas, can be dangerous and corruption at the airport itself is rampant.Travelers at the airport have been victims of personal property theft, as well as mugging and “express kidnapping” in which individuals are taken to make purchases or to withdraw as much money as possible from ATMs, often at gunpoint.The Embassy has received multiple, credible reports that individuals with what appear to be official uniforms or other credentials are involved in facilitating or perpetrating these crimes.For this reason, American citizen travelers should be wary of all strangers, even those in official uniform or carrying official identification.There are also known drug trafficking groups working from the airport.Travelers should not accept packages from anyone and should keep their luggage with them at all times.

Because of the frequency of robberies at gunpoint, travelers are encouraged to arrive during daylight hours.If not, travelers should use extra care both within and outside the airport.The Embassy strongly advises that all arriving passengers make advance plans for transportation from the airport to their place of lodging.If possible, travelers should arrange to be picked up at the airport by someone who is known to them.The Embassy has received frequent reports of armed robberies in taxicabs going to and from the airport at Maiquetía.There is no foolproof method of knowing whether a taxi driver at the airport is reliable.The fact that a taxi driver presents a credential or drives an automobile with official taxi license plates marked “libre” is no longer an indication of reliability.Incidents of taxi drivers in Caracas overcharging, robbing, and injuring passengers are common.Travelers should take care to use radio-dispatched taxis or those from reputable hotels.Travelers should call a 24-hour radio-dispatched taxi service from a public phone lobby or ask hotel, restaurant, or airline representatives to contact a licensed cab company for them. A list of transportation services used by members of the U.S. Embassy community is available on the U.S. Embassy web site at http://venezuela.usembassy.gov/.The Embassy does not vouch for the professional ability or integrity of any specific provider.The list is not meant to be an endorsement by the Department of State or the Embassy.Likewise, the absence of any individual or company does not imply lack of competence. While visiting Venezuela, Americans are encouraged to carry as little U.S. currency on them as possible and to avoid wearing expensive or flashy watches and jewelry.Due to the poor security situation, the Embassy does not recommend changing money at the international airport.Visitors should bring a major credit card, but should be aware of widespread pilfering of credit card data to make unauthorized transactions.Travelers’ checks are not recommended as they are honored in only a few locations.It is possible to exchange U.S. currency at approved exchange offices near major hotel chains in Caracas (personal checks are not accepted) and at commercial banks with some restrictions.Due to currency regulations, hotels cannot provide currency exchange.There are ATM machines throughout Venezuela.Malfunctions are common, however, and travelers should be careful to use only those in well-lit public places.ATM data has also been hacked and used to make unauthorized withdrawals from user’s accounts. Popular tourist attractions, such as the Avila National Park, are increasingly associated with violent crime.Americans planning to participate in outdoor activities in potentially isolated areas are strongly urged to travel in groups of five or more and to provide family or friends with their itineraries prior to departure. Cross-border violence, kidnapping, drug trafficking, smuggling, and cattle-rustling occur frequently in areas along the 1,000-mile long border between Venezuela and Colombia.Some kidnap victims have been released after ransom payments, while others have been murdered.In many cases, Colombian terrorists are believed to be the perpetrators.Colombia's National Liberation Army (ELN) has had a long history of kidnapping for ransom, and the Revolutionary Armed Forces of Colombia (FARC) are active in the kidnapping trade.Common criminals are also increasingly involved in kidnappings, either dealing with victim's families directly or selling the victim to terrorist groups.

In-country travel by U.S. Embassy employees, both official and private, within a 50-mile area along the entire Venezuela/Colombia border, is prohibited.The State Department warns American citizens not to travel within a 50-mile area along the entire Venezuela/Colombia border.U.S. citizens who elect to visit areas along the border region with Colombia despite this warning, apart from the Colombian terrorist threat, could encounter Venezuelan military-controlled areas and may be subject to search and arrest. The U.S. Embassy must approve in advance the official travel to Venezuela of all U.S. Government personnel.Private travel by U.S. military personnel to Venezuela requires advance approval by the U.S. Embassy.Please consult the Department of Defense Foreign Clearance Guide at https://www.fcg.pentagon.mil/ for further information.Non-military employees of the U.S. Government do not need Embassy approval for private travel. Political marches and demonstrations are frequent in Caracas and often pass without incident. Nevertheless, travelers should be aware that violence, including exchanges of gunfire, has occurred at political demonstrations in the past.Demonstrations tend to occur at or near university campuses, business centers, and gathering places such as public squares and plazas.Marches generally occur on busy thoroughfares, significantly impacting traffic.Most major tourist destinations, including coastal beach resorts and Margarita Island, have not in the past been generally affected by protest actions.The city of Merida, however, a major tourist destination in the Andes, has been the scene of frequent student demonstrations, some of them violent, including the use of firearms. Travelers should keep informed of local developments by following the local press, radio and television.Visitors should also consult their local hosts, including U.S. and Venezuelan business contacts, hotels, tour guides, and travel organizers.As circumstances warrant, the Embassy sends out messages to U.S. citizens who have registered on-line.These messages are also posted on the U.S. Citizens page of the Embassy’s web site at http://venezuela.usembassy.gov/.U.S. citizens traveling or residing in Venezuela are advised to take common-sense precautions and avoid large gatherings and demonstrations, no matter where they occur. Harassment of U.S. citizens by pro-government groups, Venezuelan airport authorities, and some segments of the police occurs but is quite limited. Venezuela’s most senior leaders, including President Chavez, regularly express anti-American sentiment.The Venezuelan government’s rhetoric against the U.S. government, its American culture and institutions, has affected attitudes in what used to be one of the most pro-American countries in the hemisphere.

Venezuela is an earthquake-prone country and is occasionally subject to torrential rains, which can cause major disasters such as the one in Vargas State in 1999.Travelers who intend to rent or purchase long-term housing in Venezuela should choose structures designed for earthquake resistance.Such individuals may wish to seek professional assistance from an architect or civil/structural engineer, as does the Embassy, when renting or purchasing a house or apartment in Venezuela.Americans already housed in such premises are also encouraged to seek a professional structural assessment of their housing.

For further information on seismic activity, you may wish to visit:

1. The Multidisciplinary Center for Earthquake Engineering Research (MCEER) web site at http://mceer.buffalo.edu/infoservice/Quakeline_Database/default.asp2. The Global Seismic Hazard Assessment Program web site at www.seismo.ethz.ch/GSHAP3. The Caribbean Disaster Mitigation Project web site at www.oas.org/CDMPFor the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts including the Worldwide Caution can be found. Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad. CRIME: Venezuela and its capital, Caracas, have one of the highest per capita murder rates in the world.Virtually all murders go unsolved.The poor neighborhoods that cover the hills around Caracas are extremely dangerous.These areas are seldom patrolled by police and should be avoided.Armed robberies are common in urban and tourist areas throughout Venezuela, even areas presumed safe and visited by tourists.Crimes committed against travelers are usually money-oriented crimes, such as theft and armed robbery.Incidents occur during daylight hours as well as at night.Many criminals are armed with guns or knives and will use force.Jewelry attracts the attention of thieves.Travelers are advised to leave jewelry items, especially expensive-looking wristwatches, at home.Gangs of thieves will often surround their victims and use a chokehold to disable them, even in crowded market areas where there is little or no police presence.Theft from hotel rooms and safe deposit boxes is a problem, and theft of unattended valuables on the beach and from rental cars parked near isolated areas or on city streets is a common occurrence.A guarded garage or locked trunk is not a guarantee against theft.Pickpockets concentrate in and around crowded bus and subway stations in downtown Caracas.Subway escalators are favored sites for "bump and rob" petty thefts by roving bands of young criminals.Many of these criminals are well dressed to allay suspicion and to blend in with crowds using the subways during rush hour.Travelers should not display money or valuables. "Express kidnappings," in which victims are seized in an attempt to get quick cash in exchange for their release, are a problem.Kidnapping of U.S. citizens and other foreign nationals, from homes, hotels, unauthorized taxis and the airport terminal has occurred.U.S. citizens should be alert to their surroundings and take necessary precautions. The Department has received reports of robberies during nighttime and early morning hours on the highways around and leading to Caracas.Reports have specifically involved cars being forced off the La Guaira highway leading from Caracas to the Maquetía International Airport, and the "Regional del Centro" highway leading from Caracas to Maracay/Valencia, at which point the victims are robbed.The Department recommends avoiding driving at night and in the early morning where possible.Drivers traveling on highways during nighttime and early morning hours should exercise caution. Police responsiveness and effectiveness in Venezuela vary drastically but generally do not meet U.S. expectations.U.S. travelers have reported robberies and other crimes committed against them by individuals wearing uniforms and purporting to be police officers or National Guard members. Incidents of piracy off the coast of Venezuela remain a concern.Some of these incidents have been especially violent, including the severe beating of a U.S. citizen in 2002, the fatal shooting of an Italian citizen in January 2004, and a machete attack on a U.S. citizen in 2005.U.S. citizen yachters should exercise a heightened level of caution in Venezuelan waters.Please consult the U.S. Coast Guard web site at http://www.uscg.mil/hq/g-o/g-opr/g-opr.htm for additional information on sailing in Venezuela.

Rules governing the sale of fuel to foreign sailors in Venezuela vary by state.U.S. citizen yachters should inquire about specific state procedures prior to attempting to purchase fuel in any given location.Failure to comply with a state’s particular requirements can result in arrest and criminal charges.

The Embassy is aware of several instances where women lured American men to Venezuela after establishing “relationships” with them over the Internet.Some of these men were robbed shortly after they arrived in Venezuela.Others were recruited to act as narcotics couriers or “drug mules.”In three instances, the Americans were arrested at the airport with narcotics in their possession and served extended jail terms in Venezuela. In many countries around the world, counterfeit and pirated goods are widely available.Transactions involving such products may be illegal under local law.In addition, bringing them back to the United States may result in forfeitures and/or fines.More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm. INFORMATION FOR VICTIMS OF CRIME:The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.Although the investigation and prosecution of the crime are solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed. See our information on Victims of Crime. MEDICAL FACILITIES AND HEALTH INFORMATION:Medical care at private hospitals and clinics in Caracas and other major cities is generally good.Public hospitals and clinics generally provide a lower level of care and basic supplies at public facilities may be in short supply or unavailable.Cash payment is usually required in advance of the provision of medical services at private facilities, although some facilities will accept credit cards.Patients who cannot provide advance payment may be referred to a public hospital for treatment.Private companies that require the patient to be a subscriber to the service or provide cash payment in advance generally provide the most effective ambulance services.Public ambulance service is unreliable.U.S. citizens should be aware that due to the currency restrictions in effect in Venezuela they might find it difficult to receive wire transfers from abroad, whether through a bank or Western Union.Such wire transfers cannot be used reliably as a source of emergency funds.U.S. citizens traveling to Venezuela may also find it difficult to obtain certain prescription drugs, particularly name brands, and should ensure that they have sufficient quantities of all medications for the duration of their stay. Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.Further health information for travelers is available at http://www.who.int/ith/en. MEDICAL INSURANCE:The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.Please see our information on medical insurance overseas. TRAFFIC SAFETY AND ROAD CONDITIONS:While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.The information below concerning Venezuela is provided for general reference only, and may not be totally accurate in a particular location or circumstance. Driving regulations in Venezuela are similar to those in the United States, although many drivers do not obey them.Defensive driving is a necessity.Child car seats and seatbelts are not required and are seldom available in rental cars and taxis.Outside the major cities, night driving can be dangerous because of unmarked road damage or repairs in progress, unlighted vehicles, and livestock.Even in urban areas, road damage is often marked by a pile of rocks or sticks left by passersby near or in the pothole or crevice, without flares or other devices to highlight the danger.Traffic jams are common within Caracas during most of the day and are frequently exploited by criminals. Stops at National Guard and local police checkpoints are mandatory.Drivers should follow all National Guard instructions and be prepared to show vehicle and insurance papers and passports.Vehicles may be searched.Inexpensive bus service is available to most destinations throughout the country, but the high incidence of criminal activity on public transportation makes bus travel inadvisable.Peak holiday travel occurs during summer and winter school breaks and major civil and religious holidays, including Carnival, Easter, Christmas and New Year's holidays.Lengthy delays due to road congestion are common during these peak periods. Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Venezuela’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Venezuela’s air carrier operations.For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa/. SPECIAL CIRCUMSTANCES: In February 2007, the National Assembly granted President Chavez the authority to rule by decree in 11 general areas for 18 months.Laws issued by President Chavez under this authority become effective immediately after their publication in the government legislative gazette.As a result, laws directly impacting U.S. Citizens or their interests in Venezuela may come into force with little or no warning.U.S. Citizens are advised to carefully monitor changes in Venezuelan law. Venezuela is also slated to hold gubernatorial and mayoral elections nation-wide in late 2008.These electoral races are expected to generate extensive political campaigning from pro-government and opposition parties. The government of Venezuela implemented rigid foreign exchange controls in 2003, including a fixed official rate of exchange.Foreign exchange transactions must take place through exchange houses or commercial banks at the official rate.As of October 2005 it is no longer possible to exchange money at hotels.Currency exchange for tourists can be arranged at "casas de cambio" (exchange houses).There are exchange houses located near most major hotels.It is also possible to exchange money at commercial banks; however, visitors should be aware that the exchange would not be immediate.Exchanges through commercial banks must first be approved by the Commission for Administration of Foreign Currencies (CADIVI).This requires a registration process, which delays the exchange.The exchange control mechanisms also require the exchange houses and commercial banks to obtain authorization from CADIVI to trade Bolívares Fuertes (the local currency) into U.S. dollars.Outside the major cities, a good supply of Venezuelan currency is necessary, as it may be difficult to find exchange houses.The Embassy cannot provide currency exchange services. Travelers will likely encounter individuals in Venezuela who are willing to exchange Bolívares Fuertes for U.S. dollars at a rate significantly higher than the official rate of exchange.These "parallel market" currency exchanges are prohibited under the Venezuelan foreign exchange controls.Travelers engaging in such activity may be detained by the Venezuelan authorities.Additionally, in accordance with an October 2005 law, any person who exchanges more than 10,000 U.S. dollars in the course of a year through unofficial means is subject to a fine of double the amount exchanged.If the amount exceeds 20,000 U.S. dollars the penalty is two to six years imprisonment.Any person who transports more than 10,000 U.S. dollars into or out of Venezuela by any means must declare this amount to customs officials. Credit cards are generally accepted at most upscale tourist establishments, but foreign exchange controls have made credit card acceptance less common than in the past.Visa, MasterCard, and American Express have representatives in Venezuela.Due to the prevalence of credit card fraud in Venezuela, travelers should exercise caution in using their credit cards and should check statements regularly to ensure that no unauthorized charges have been made.Most major cities have ATMs with 24-hour service where users may withdraw local currency, but many of these ATMs will not accept U.S.-issued debit cards. Venezuelan customs authorities may enforce strict regulations concerning temporary importation into or export from Venezuela of items such as plant and animal products, firearms, medications, archaeological or "cultural heritage" items, and pirated copies of copyrighted articles.It is advisable to contact the Embassy of Venezuela in Washington or one of Venezuela's consulates in the United States for specific information regarding customs requirements.Please see our Customs Information. CRIMINAL PENALTIES:While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.Penalties for breaking the law can be more severe than in the United States for similar offenses.Persons violating Venezuela’s laws, even unknowingly, may be expelled, arrested, or imprisoned.Penalties for possession, use, or trafficking in illegal drugs in Venezuela are severe, and convicted offenders can expect long jail sentences and heavy fines.Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.Please see our information on Criminal Penalties. CHILDREN'S ISSUES:For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:Americans living or traveling in Venezuela are encouraged to register with the U.S. Embassy in Caracas through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Venezuela.Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.By registering, American citizens make it easier for the Embassy to contact them in case of emergency.The Consular Section is open for American Citizen Services from 8:00 a.m. to 10:30 a.m. Monday through Friday, excluding U.S. and Venezuelan holidays.The U.S. Embassy is located at Calle Suapure and Calle F, Colinas de Valle Arriba, Caracas.The telephone number during regular business hours (8:00 a.m. to 5:00 p.m.) is (58) (212) 975-6411.In case of an after-hours emergency, callers should dial (58) (212) 907-8400.The Embassy’s web site, http://venezuela.usembassy.gov/ , contains complete information about services provided and hours of operation. A part-time consular agent in Maracaibo provides services for U.S. citizens in western Venezuela.The agent is available to the public every Monday from 8:15 am to 12:15 pm, at the Centro Venezolano Americano del Zulia (CEVAZ), Calle 63 No. 3E-60, Maracaibo; telephone 58)(0261) 793-2101 or 793-3488.*

Caracas, March 16, 2020 (AFP) - Venezuelan President Nicolas Maduro on Sunday ordered a "collective quarantine" in seven states, including the capital Caracas, from Monday to stem the spread of the new coronavirus pandemic. Elsewhere in Latin America, Argentina and Colombia were amongst several countries to announce new travel restrictions and El Salvador declared a state of emergency in stepped-up efforts to try to protect against the virus. The region did not report its first new-coronavirus case until February 26, by which time it was well established in Asia and Europe. But Latin America has seen an acceleration in reported cases, with more than 550 people now infected and six deaths. In Venezuela, all activities in the seven states are to be suspended from 5:00 am Monday.

Food distribution, health services, transport and security are exempted, Maduro said in a television address to his crisis-devastated nation where the economy had already collapsed long before the pandemic struck. "It's not a collective vacation, no. It's a collective quarantine that deserves great social discipline, great self-control," said Maduro, adding that it meant people should stay "at home." Caracas alone is home to six million people. This latest measure to combat the global pandemic comes after Maduro previously banned flights to and from Europe, Colombia, Panama and the Dominican Republic. He also suspended school and university classes, and sports events.

Venezuela reported seven new cases of the COVID-19 illness on Sunday, taking its total to 17. Maduro has said his response was inspired by that of China, one of Venezuela's main commercial allies. China, where the virus originated, put tens of millions of people under lockdown to help contain the spread of the virus, which has affected more than 80,000 Chinese and killed more than 3,000. "The only way to contain the channels of transmission is to enter in a... drastic phase of collective quarantine throughout the country," said Maduro.

- Argentina, Colombia close borders -Argentina's President Alberto Fernandez announced the closure of the country's borders and a suspension of school classes until the end of the month. Fernandez said the border closure was only for people entering the country and there was no impediment to leaving Argentina. Colombian President Ivan Duque announced on Twitter that "from March 16, entry for non nationals and non residents to Colombia will be restricted." Colombians and foreign residents can still enter the country but must respect "an obligatory two-week isolation," he said. The four Mercosur trade bloc countries -- Brazil, Argentina, Paraguay and Uruguay -- revealed a plan to "reduce border entries." Paraguay's President Mario Abdo Benitez said the countries would discuss a partial closure of borders "to people, not merchandise" on Monday.

Chile suspended school classes and barred cruise ships from its ports. On Saturday it quarantined two cruise ships after an 85-year-old Briton tested positive for the virus. Chile has recorded 75 positive cases since March 3. President Sebastian Pinera also reduced from 500 to 200 the maximum size of permitted public events and brought forward a mass flu vaccination program that aims to immunise eight million people. However, there is no vaccine for the new coronavirus currently ravaging the world. Peru, which had 43 confirmed cases, likewise barred cruise ships from docking at its ports for at least 30 days. Local press reported that the government is expected to announce a nationwide home-stay quarantine.

- Costa Rica blocks night life -In Cenral America, Costa Rican health authorities ordered all bars, casinos and night clubs to close for one month. Health Minister Daniel Salas also called on people to avoid going outside unless it was strictly necessary. Late on Saturday, El Salvador's Congress declared a state of emergency and approved a partial suspension of the country's constitution, despite not having recorded any cases of new coronavirus. The measures include a restriction on free movement and assembly for 30 days, allowing health officials to ban public gatherings. In sport, Brazil and Mexico suspended all professional football matches until further notice. Brazil is the worst affected country in Latin America with 176 reported cases. In the Dominican Republic, municipal elections went ahead on Sunday, although the government announced it was suspending flights to and from Europe, China, South Korea and Iran from Monday.

On 13 Nov 2019, the Venezuela International Health Regulations (IHR) National Focal Point (NFP) and the Venezuela PAHO/WHO Country Office shared information about a confirmed case of yellow fever in Bolivar State. The case-patient is a 46-year-old male resident of the municipality of Gran Sabana, Bolivar State. He was in the locality of Uriman municipality of Gran Sabana within the 19 days prior to the onset of symptoms. Symptom onset was on 14 Sep 2019, and included fever, chills, nausea, vomiting, epistaxis, petechiae, and diarrhoea. On 26 Sep 2019, he visited a public hospital in the municipality of Heres where his condition deteriorated, with moderate dehydration, bleeding from the gums, jaundice, choluria, abdominal pain, and hepatomegaly. As of 13 Nov 2019, the patient remains hospitalized with chronic renal failure and moderate anaemia.

On 26 Sep 2019, the 1st serum sample was sent to the National Reference Laboratory, the National Institute of Hygiene "Rafael Rangel" per its acronym in Spanish, IHRR, in Caracas. On 13 Nov 2019, the sample tested positive for yellow fever by reverse-transcriptase polymerase chain reaction (RT-PCR), and negative for dengue on 14 Nov 2019 by RT-PCR. On 10 Oct 2019, a 2nd serum sample was taken and sent to the IHRR, for which the results are still pending.

Most of the territory of Venezuela is considered as at risk for sylvatic yellow fever, and this case marks the 1st confirmed autochthonous case of yellow fever diagnosed in Venezuela since 2005.

Public health response

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A joint investigation team (WHO Country Office and the Venezuela Ministry of Health) was deployed on 12 Nov [2019] to characterize the risk and develop the response plan. PAHO Immunizations (IM) Unit along with the Revolving Fund have secured a donation of 571 000 doses of yellow fever vaccine from UNICEF that arrived in the country at the end of October [2019].

The local public health authorities have strengthened the active and passive epidemiological surveillance activities in humans and non-human primates. Additionally, strategic vaccination activities have been planned.

WHO risk assessment

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Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes and has the potential to spread rapidly and cause serious public health impact. There is no specific treatment, although the disease is preventable using a single dose of yellow fever vaccine, which provides immunity for life. Supportive care is required to treat dehydration, respiratory failure, and fever; antibiotics are recommended to treat associated bacterial infections.

The origin of the infection of this case is likely to be sylvatic, in an area determined as at risk for yellow fever. Venezuela is considered at risk for yellow fever transmission.

WHO advice

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This yellow fever case report illustrates the importance of maintaining awareness and strong surveillance systems (including laboratory capacity) and high coverage of yellow fever vaccination, especially in areas with a favourable ecosystem for yellow fever transmission and indigenous groups.

- Vaccination against yellow fever at least 10 days prior to the travel is recommended for all travelers aged 9 months or above traveling to Venezuela, except for travelers whose itineraries are limited to the following areas:

-- the entire states of Aragua, Carabobo, Miranda, Vargas and Yaracuy, and the Distrito Federal.

- It is not recommended for travelers whose itineraries are limited to the following areas:

-- all areas above 2300 m in the states of Merida, Trujillo and Tachira;

-- the states of Falcon and Lara; Margarita Island;

-- the capital city of Caracas and the city of Valencia (please see the map here:

- The vaccine is contraindicated in children aged under 6 months and is not recommended for those aged between 6 and 8 months, except during epidemics when the risk of infection with yellow fever virus may be very high.

- Caution is recommended before vaccinating people aged 60 years or more against yellow fever, and a risk-benefit assessment should be performed for any person 60 years or more of age who has not been vaccinated and for whom the vaccine is normally recommended. - A single dose of WHO-approved yellow fever vaccine is sufficient to confer life-long protection against yellow fever disease. A booster dose of the vaccine is not needed.

- Yellow fever virus may be transmitted not only in areas of high endemicity but also in areas of low endemicity if a traveller's itinerary results in heavy exposure to mosquitoes (e.g., during prolonged travel in rural areas). WHO recommends as a general precaution to avoid mosquito bites; the highest risk for transmission of yellow fever virus is during the day and early evening.

- A yellow fever vaccination certificate is required for travellers aged one year of age or older, arriving from Brazil, and for travellers having transited for more than 12 hours through an airport in Brazil. Travelers should be aware that the absence of a requirement for vaccination does not imply that there is no risk of exposure to yellow fever in the country. Vaccination coverage in some populations might be suboptimal, particularly among indigenous communities.

- International certificates of vaccination against yellow fever become valid 10 days after primary vaccination and remain valid for the duration of the life of the person vaccinated. A booster dose after 10 years is not necessary for protection and can no longer be required for international travelers as a condition of entry into a country.

- Awareness of symptoms and signs of yellow fever.

- Promotion of healthcare-seeking advice while traveling and upon return from an area at risk for yellow fever transmission, especially to a country where the establishment of a local cycle of transmission is possible (i.e., where the competent vector is present).

WHO encourages Member States to take all actions necessary to keep travelers well informed of risks and of preventive measures including vaccination. Travelers should also be made aware of yellow fever signs and symptoms and be instructed to seek rapid medical advice when presenting signs after possible exposure.

WHO reminds Members States to strengthen the control checks of immunization status of travelers to all potentially endemic areas. Viraemic returning travelers infected in endemic areas may pose a risk for the establishment of local cycles of yellow fever transmission in areas where a competent vector is present. If there are medical grounds for not getting vaccinated, this must be certified by the appropriate authorities.

WHO does not recommend any general travel or trade restrictions be applied to Venezuela based on the information available for this event.

[This report provides additional information that was unavailable in the initial report. The case is now confirmed as yellow fever (YF), and the locality in Bolivar state where the man was infected is now identified as the municipality of Gran Sabana. The likelihood that this is a case of sylvan (forest) transmission is stated. The arrival of a substantial lot of YF vaccine is reported. One hopes that the plans for a vaccination campaign are completed and put into action quickly to prevent ongoing transmission in an urban cycle involving _Aedes aegypti_ that are doubtless abundant in this locality. - ProMED Mod.TY]

The Venezuelan Public Health Society and the Let's Defend The National Epidemiology Network issued an alert after a case of yellow fever was confirmed in the state of Bolivar, after 14 years without the disease. The Health Ministry hasn't published information about the case or issued an alert, but Venezuela must formally report it to international institutions, due to the risk to a population that isn't vaccinated, having the vector (mosquitoes) in all of the territory (increasing the odds of an epidemic), and the poor access to an epidemiologic report [about the case]. Doctor Julio Castro wrote about the case for Prodavinci. [Byline: Naky Soto]

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[There is little information about this case: where and when it occurred in Bolivar state, tests used to diagnose the case, condition of the patient, and any follow-up measures taken by public health authorities. Yellow fever (YF) virus is endemic in Venezuela as it is in many South American countries.

The most recent ProMED-mail report of YF in Venezuela was in 2010, in Anzoategui state, where there were 3 probable YF cases in monkeys. This outbreak was enzootic, as determined by the Ministry of Health (see Yellow fever - South America: Venezuela (AN) monkey, susp http://promedmail.org/post/20101112.4114).

Presumably, this current case is one of spill-over from the sylvan (forest) transmission cycle. Maintenance of a high level (80-90%) of coverage is essential to prevent cases and avoid outbreaks involving the urban cycle with _Aedes aegypti_ transmission. - ProMED Mod.TY]

Caracas, Oct 8, 2019 (AFP) - The small waiting room at the home of self-styled healer "Brother Guayanes" in Caracas' rundown Petare district fills up quickly with patients -- business has never been better. With Venezuela's chronic medicine shortages and hyperinflation, more and more people are turning to alternative medicine to treat common ailments in the crisis-wracked South American country. "We go to the hospital and there's nothing there. They don't have medicines, or they're too expensive, what are we to do?" said Rosa Saez, 77, who has come to get treatment for a painful arm. Carlos Rosales -- he uses the more ceremonious "Brother Guayanes" for his business -- is finishing up a "spiritual intervention" on a patient in what passes for his surgery. The patient lies, eyes closed, on a cot as, in a series of swishes and clicks, the healer waves five pairs of scissors one after another over his prone body. The healer says he performs 200 such interventions a week in a dim, candle-lit room that features two camp beds and an array of plaster statues that Rosales says represent "spiritual entities". A regular visitor to the spiritual center, Saez says she has faith in Rosales' methods: "He healed my kidneys."

- Natural healing -All across Venezuela, but particularly in poor areas like Petare, patients cannot hope to afford the price of medicines that due to the economic crisis, have become exceedingly rare. Venezuela's pharmacists' federation say pharmacies and hospitals have on average only about 20 percent of the medicine stock needed. Rosales' clinic is muggy with the smell of tobacco. A crucifix suspended from a chain around his neck, he practices a seeming mixture of smoke-blowing shamanism, plant-based medicine and mainstream religion. Posters hung near the entrance remind clients to arrive with a candle and tobacco and "Don't forget that payment is in cash". Much like a general practitioner, Rosales spends time consulting with his patients, examining them with a stethoscope, before offering a diagnosis. Often he prescribes potions based on plants and fruit, such as pineapple and a type of local squash known as chayote. "We know medicines are necessary," he says. "I'm not against medicine, but my medicine is botany."

- Plants replace drugs -At her stall in a downtown Caracas market, 72-year-old Lilia Reyes says she has seen her trade in medicinal plants flourish. "I can't keep up with the demand," she said at her stall, bathed in the aroma of camomile, one of the 150 plants she sells. Careless consumption of some herbs can be deadly, warns Grismery Morillo. A doctor at a Caracas public hospital, she says she has seen many cases of acute liver failure in people who have eaten certain roots. According to Venezuela's opposition parties, some 300,000 chronically ill people are in danger of dying from the shortages of medicines.

But despite the risks, people like Carmen Teresa say they have no alternative. In the kitchen of her restaurant which closed down three years ago as the economic crisis took hold, the 58-year-old Colombian prepares an infusion of fig leaves to treat "diabetic neuropathy". The painkillers needed for the condition are "too expensive" and prices are going up due to hyperinflation, so she is cutting back on the pills and supplementing her treatment with herbal infusions. She needs at least four tablets a day to keep her diabetes at bay. Her mother, bedridden since breaking a leg a year ago, suffers from Alzheimer's disease and needs five pills a day for hypertension. "I'm still taking my pills, but I reduced the dose," says Teresa, who is also replacing cholesterol pills with lemon juice.

More than 10 cases of malaria have been reported in the Boyaca III sector of Barcelona (Anzoategui, Venezuela) in the past 2 weeks. Of these cases, 2 are young children aged 1 and 2 years old, infected after the bite of the _Aedes aegypti_ mosquito.

Maria Febres, a nurse and resident of the community, states that the malaria outbreak is due to the lack of weeding and cleaning in the channel that crosses the Boyaca III sector, where more than 500 families reside. "We have 12 cases of malaria in the sector. We need them to come clean the canal, which has not received adequate maintenance for 2 years, putting many families at risk of contracting malaria due to the proliferation of mosquitoes," she said.

The nurse told the infociudadano [city correspondent] of El Pitazo [local media company], Eduardo Mora, that the sector has not been fumigated since 2018, and called on Public Health and Malariology officials to visit the area and verify what is happening. "The most affected area is Boyaca III sector II, because we have a Simoncito [children's centre -- so-called in honour of Simon Bolivar] there and the children who go every day are the ones most at risk of being bitten by an infected mosquito and, thus, getting malaria," said Maria. [Byline: Giovanna Pellicani]

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[Over the past 5 years, the malaria control programme in Venezuela has not be functioning, and malaria has resurged in most of the country, which is well illustrated by this report. - ProMED Mod.EP]

Sierra Leone

Sierra Leone - US Consular Information SheetJune 11, 2007 COUNTRY DESCRIPTION: Sierra Leone is a developing country in western Africa still recovering from a ten-year civil war that ended in 2002.English is the official language, but Kri
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, an English-based language, is widely used.Tourist facilities in the capital, Freetown, are limited; elsewhere, they are rudimentary or nonexistent.Read the Department of State Background Notes on Sierra Leone for additional information.

ENTRY/EXIT REQUIREMENTS:A passport and visa are required.Visitors are strongly encouraged to obtain visas in advance of travel to Sierra Leone.Visitors to Sierra Leone are required to show International Certificates of Vaccination (yellow card) upon arrival at the airport with a record of vaccination against yellow fever. See our Foreign Entry Requirements brochure for more information on Sierra Leone and other countries.The Embassy of Sierra Leone is located at 1701 19th Street NW, Washington, DC 20009; telephone (202) 939-9261.The Embassy also maintains a website at www.embassyofsierraleone.org.Information may also be obtained from the Sierra Leonean Mission to the United Nations, 245 East 49th St., New York, NY 10017; telephone (212) 688-1656 and from the website of the Sierra Leonean High Commission in London at http://www.slhc-uk.org.uk/.Overseas, inquiries should be made at the nearest Sierra Leonean embassy or consulate.

See Entry and Exit Requirements for more information pertaining to dual nationality and the prevention of international child abduction.Please refer to our Customs Information to learn more about customs regulations.

SAFETY AND SECURITY:Security in Sierra Leone has improved significantly since the end of the civil war in 2002.The United Nations Peacekeeping Mission in Sierra Leone (UNAMSIL) withdrew in December 2005 and Sierra Leone resumed responsibilities for its own security. The Sierra Leonean police are working to improve their professionalism and capabilities, but fall short of American standards in response time, communications, and specialty skills.

Areas outside Freetown lack most basic services. Embassy employees are free to travel throughout Sierra Leone.Travelers are urged to exercise caution, however, especially when traveling beyond the capital.Road conditions are hazardous and serious vehicle accidents are common.Emergency response to vehicular and other accidents ranges from slow to nonexistent.

There are occasional unauthorized, possibly armed, roadblocks outside Freetown, where travelers might be asked to pay a small amount of money to the personnel manning the roadblock.Because many Sierra Leoneans do not speak English, especially outside of Freetown, it can be difficult for foreigners to communicate their identity.Public demonstrations are rare but can turn violent.U.S. citizens should are advised to avoid large crowds, political rallies, and street demonstrations, and maintain security awareness at all times.

For the latest security information, Americans traveling abroad should regularly monitor the Department's Internet web site where the current Worldwide Caution Public Announcement, Travel Warnings and Public Announcements can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad. CRIME:Entrenched poverty in Sierra Leone has led to criminality.There has been an increase in homicide, armed robbery, and residential burglary.Petty crime and pick pocketing of wallets, cell phones, and passports are very common.Law enforcement authorities usually respond to crimes slowly, if at all.Police investigative response are often incomplete and don’t provide support to victims.Inefficiency is a serious problem at all levels within the government of Sierra Leone.Americans traveling to or residing in Sierra Leone should maintain a heightened sense of awareness of their surroundings to help avoid becoming the victims of crime.

Business fraud is rampant and the perpetrators often target foreigners, including Americans.Schemes previously associated with Nigeria are now prevalent throughout West Africa, including Sierra Leone, and pose a danger of grave financial loss.Typically these scams begin with unsolicited communication (usually e-mails) from strangers who promise quick financial gain, often by transferring large sums of money or valuables out of the country, but then require a series of "advance fees" to be paid, such as fees for legal documents or taxes.Of course, the final payoff does not exist; the purpose of the scam is simply to collect the advance fees.A common variation is the scammer’s claim to be a refugee or émigré of a prominent West African family, or a relative of a present or former political leader who needs assistance in transferring large sums of cash.Still other variations appear to be legitimate business deals that require advance payments on contracts.Sometimes victims are convinced to provide bank account and credit card information and financial authorization that drains their accounts, incurs large debts against their credit, and takes their life savings.

The best way to avoid becoming a victim of advance-fee fraud is common sense – if a proposition looks too good to be true, it probably is.You should carefully check and research any unsolicited business proposal before committing any funds, providing any goods or services, or undertaking any travel.It is virtually impossible to recover money lost through these scams. Please see the Department of State’s brochures on Advance Fee Business Scams and on International Financial Scams for more information.

INFORMATION FOR VICTIMS OF CRIME:The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:Quality and comprehensive medical services are very limited in Freetown, and are almost nonexistent for all but most minor treatment outside of the capital.Persons with unstable chronic medical conditions that require on-going medical treatment or medications are discouraged from traveling to Sierra Leone.Medicines are in short supply and due to inadequate diagnostic equipment, lack of medical resources and limited medical specialty personnel, complex diagnosis and treatment are unavailable.The quality of medications in Sierra Leone is inconsistent and counterfeit drugs remain a problem.Local pharmacies are generally unreliable. In the event medications are needed, such as over-the-counter medication, antibiotics, allergy remedies, or malaria prophylaxis, travelers may contact U.S. Embassy Health Unit personnel to receive general information about reliable pharmacies.

Medical facilities in Sierra Leone are scarce and for the most part sub-standard; outside the capital, standards are even lower.There is no ambulance service in Sierra Leone, trauma care is extremely limited, and local hospitals should only be used in the event of an extreme medical emergency.Many primary health care workers, especially in rural areas, lack adequate professional training.Instances of misdiagnosis, improper treatment, and the administration of improper drugs have been reported.Life-threatening emergencies often require evacuation by air ambulance at the patient's expense.For a list of hospitals, visit our website at http://freetown.usembassy.gov/ .

Gastrointestinal diseases and malaria pose serious risk to travelers in Sierra Leone.For additional information on malaria, including protective measures, see the CDC Travelers’ Health web site at http://www.cdc.gov/malaria/.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s internet site at http://www.cdc.gov/travel.For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) website at http://www.who.int/en.Further health information for travelers is available at http://www.who.int/ith.

MEDICAL INSURANCE:The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.Please see our information on medical insurance overseas. TRAFFIC SAFETY AND ROAD CONDITIONS:While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.The information below concerning Sierra Leone is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Most main roads in Freetown are narrow and paved but have potholes; extremely narrow unpaved side streets are generally navigable.Most roads outside Freetown are unpaved and are generally passable with a 4-wheel drive vehicle.However, certain stretches of mapped road are often impassable during the rainy season, which usually lasts from May to September.During the rainy season, add several hours to travel time between Freetown and outlying areas.There is a major road repair and resurfacing program going on throughout the country that is slowly improving the quality of roads.Public transport (bus or group taxi) is erratic, unsafe, and not recommended.U.S. government employees are prohibited from using public transportation except for taxis that operate in conjunction with an approved hotel and that are rented on a daily basis.

Many vehicles on the road in Sierra Leone are unsafe and accidents resulting from the poor condition of these vehicles, including multi-vehicle accidents, are common.Many drivers on the road in Sierra Leone are inexperienced and often drive without proper license or training.Serious accidents are common, especially outside of Freetown, where the relative lack of traffic allows for greater speeds.The chance of being involved in an accident increases greatly when traveling at night, and Embassy officials are not authorized to travel outside of major cities after dark.

Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service between the United States and Sierra Leone, the U.S. Federal Aviation Administration (FAA) has not assessed Sierra Leone’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.For more information, travelers may visit the FAA’s Internet website at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

Passengers departing Freetown on certain airlines should expect to pay an airport tax of $40.00 (payable in U.S. Dollars).Several regional airlines service Freetown’s Lungi International Airport; however, it is not uncommon for them to alter scheduled stops, cancel or postpone flights on short notice, and overbook flights.Travelers may experience unexpected delays even after checking in and must be prepared to handle alternate ticketing and/or increased food and lodging expenses.European carriers are typically more reliable.American citizens departing Lungi Airport have reported incidents of attempted extortion by officials claiming that travel documents were not in order.Luggage can often be lost or pilfered.

Lungi Airport is located across a large body of water from Freetown.There are helicopter and ferry services in connection with most major flights to transport passengers to the capital; however, the ferry service has frequent delays.It should be noted that the ferry terminal is located in East Freetown, which has a higher crime rate than other parts of the capital.Embassy personnel use available helicopter services, which usually cost $50 each way, to transit from Freetown to the airport.

SPECIAL CIRCUMSTANCES:Sierra Leone is a cash economy; however, an anti-money laundering law passed in July 2005 prohibits importing more than $10,000 in cash except through a financial institution.Travelers are advised not to use credit cards in Sierra Leone because very few facilities accept them and there is a serious risk that using a card will lead to the number being stolen for use in fraudulent transactions.There are no ATMs connected to international networks.Travelers' checks are not usually accepted as payment; however, travelers’ checks can be cashed at some banks including Sierra Leone Commercial Bank, Standard Chartered Bank and Rokel Commercial Bank.The traveler must, however, have proof of identification and a signed receipt by the institution where the travelers’ checks were purchased.Currency exchanges should be handled through a bank or established foreign exchange bureau.Exchanging money with street vendors is dangerous because criminals may "mark" such people for future attack and there is the risk of receiving counterfeit currency.

Sierra Leone's customs authorities enforce strict regulations concerning the export of gems and precious minerals, such as diamonds and gold.All mineral resources, including gold and diamonds, belong to the State and only the government of Sierra Leone can issue mining and export licenses.The legal authority for the issuance of licenses is vested in the Ministry of Mines and Mineral Resources.Failure to comply with relevant legislation can lead to serious criminal penalties.For further information on mining activities in Sierra Leone, contact the Ministry of Mines and Mineral Resources:The Director of Mines, Ministry of Mines and Mineral Resources, Fifth Floor, Youyi Building, Brookfields, Freetown, Sierra Leone; tel. (232-22) 240-420 or 240-176; fax (232-22) 240-574.

Corruption is a problem in Sierra Leone.Travelers requesting service from government officials at any level may be asked for bribes.You should report corrupt government officials to the Anti-Corruption Commission at one of the following locations:The Sierra Leone Anti-Corruption Commission, 3 Gloucester Street, Freetown; 14a Lightfoot Boston Street, Freetown; 37 Kissy Town Road, Bo, Southern Province; Independence Square, Rogbaneh Road, Makeni; tel. (232- 22) 229-984 or 227-100 or 221-701; fax (232-22) 221-900; email: acc@sierratel.sl or info@anticorruption.sl;and websites www.anticorruptionsl.org/anonymous.html and www.anticorruptionsl.org.

You must obtain official permission to photograph government buildings, airports, bridges, or official facilities including the Special Court for Sierra Leone and the American Embassy.Areas where photography is prohibited may not be clearly marked or defined.People sometimes do not want to be photographed for religious reasons or may want to be paid for posing.Photographers should ask permission before taking someone’s picture.

U.S. citizens who are also Sierra Leonean nationals must provide proof of payment of taxes on revenues earned in Sierra Leone before being granted clearance to depart the country.The Government of Sierra Leone now recognizes dual U.S.-Sierra Leonean citizenship; however; the U.S. Embassy may have difficulty assisting American citizens involved in legal or criminal proceedings if they entered the country on a Sierra Leonean passport.

Please see our Customs Information.

CRIMINAL PENALTIES:While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.Sierra Leone’s judiciary is under-funded and overburdened, and offenders often must endure lengthy pre-trial or pre-hearing delays and detention.Penalties for breaking the law can be more severe than in the United States for similar offenses.Persons violating Sierra Leone laws, even unknowingly, may be expelled, arrested or imprisoned.Penalties for possession, use, or trafficking in illegal drugs in Sierra Leone are severe, and convicted offenders can expect long jail sentences and heavy fines.Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.Please see our information on Criminal Penalties.

Travelers should carefully check their passport to see the length of time they are permitted to remain in the country and the validity of their visa.Travelers leaving the country with an expired visa may incur additional charges.Any Sierra Leonean visa issues can be regulated at the immigration office at Rawdon Street in Freetown.

CHILDREN'S ISSUES:For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues website.

A significant number of American prospective adoptive parents have found that Sierra Leonean children offered for adoption are not orphans under U.S. immigration law, which has ultimately resulted in denials of U.S. immigrant visas for children they adopt in Sierra Leonean courts.Please refer to the Sierra Leone adoption flyer for more information.

REGISTRATION / EMBASSY LOCATION:Americans living or traveling in Sierra Leone are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website and to obtain updated information on travel and security within Sierra Leone.Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.The U.S. Embassy is located at Leicester Square, Regent; tel. (232) (22) 515 000 or (232) (76) 515 000; fax (232) (22) 515 355.The Embassy maintains a home page on the Internet at http://freetown.usembassy.gov/.*

Freetown, May 1, 2020 (AFP) - Sierra Leone's President Julius Maada Bio has extended a coronavirus lockdown for three days from Sunday due to the spread of the virus in the poor West African nation. There are fears that the nation of 7.5 million people is particularly exposed to an outbreak due to poverty and a fragile health care system. There have been 124 recorded cases and seven deaths so far.

The former British colony was badly hit by the 2014-2016 West African Ebola crisis, which killed almost 4,000 people in the country. "Epidemiological data and other evidence indicate that there is community transmission of #COVID-19 in #SierraLeone," Bio said in a tweet posted late Thursday. "I therefore declare a three-day nationwide lockdown covering the period Sunday, 3rd May to Tuesday, 5th of May, 2020." Sierra Leone has banned travel between regions, imposed a night curfew, closed its borders and schools and banned international flights. The first COVID-19 case in the country was declared on March 30, long after many African nations.

Freetown, March 31, 2020 (AFP) - Sierra Leone has recorded its first case of the new coronavirus, the government said on Tuesday, making it the latest African country to register an infection. In a televised press conference, President Julius Maada Bio said that a 37-year-old man who arrived in the country from France on March 16 had tested positive. The man had been quarantined on arrival in the West African state, Bio said. "It was not a matter of whether, but when. Ladies and gentlemen, the when is here," the president said.

Sierra Leone had been one of the few countries in Africa to have reported zero cases, despite neighbouring Guinea and Liberia having detected infections. There are fears that, like its neighbours, the poor nation of 7.5 million people is particularly exposed to an outbreak. The former British colony was badly hit by the 2014-2016 West African Ebola crisis, which killed almost 4,000 people in Sierra Leone. On Tuesday, Bio said authorities were aggressively tracing people who may have come into contact with the infected patient, and urged people to report anyone with coronavirus symptoms to the authorities.

The government had already announcement anti-virus measures. Land borders are closed, international flights banned, and schools were shut from Tuesday until further notice, among other measures. "The government will respond rapidly to changes in the situation by announcing additional enhanced measures," Bio said. Six of Africa's 54 nations have been spared the coronavirus to date: South Sudan, Burundi, Sao Tome and Principe, Malawi, Lesotho and Comoros.

Freetown, March 19, 2020 (AFP) - Sierra Leone on Thursday said it would suspend all international flights in and out of the impoverished West African state in a bid to prevent the spread of coronavirus. The transport ministry said in a statement that the measure will take effect on Saturday and remain in place until further notice. Emergency flights will be the "only exception," it said. Sierra Leone has yet to record a coronavirus case, however, its neighbouring countries Guinea and Liberia have both done so. The former British colony was badly hit by the 2014-2016 West Africa Ebola outbreak, which killed almost 4,000 people in the country.

Scientists have detected Marburg virus in fruit bats in Sierra Leone, marking the 1st time the deadly virus has been found in West Africa. A total of 11 Egyptian rousette fruit bats tested positive for active Marburg virus infection. Research teams caught the bats separately in 3 health districts.

The presence of Marburg virus, a close relative to Ebola virus that also causes hemorrhagic disease in people, was detected in advance of any reported cases of human illness in Sierra Leone. However, the virus's presence in bats means people who live nearby could be at risk for becoming infected. No outbreaks have been reported to date.

The findings, based on PCR, antibody, and virus isolation data, were officially published today [24 Jan 2020] in the journal Nature Communications. Preliminary findings were announced earlier in December 2018 to ensure rapid notification to the citizens of Sierra Leone and the international health community.

The paper highlights the value of collaborating with government and key stakeholders across human, animal, and environmental sectors to engage at-risk communities about the discovery, address health concerns, and communicate risk-reduction strategies before recognized spillovers occur.

Marburg virus was detected by projects led by the Centers for Disease Control and Prevention, the USAID-funded PREDICT project led by the One Health Institute at the UC Davis School of Veterinary Medicine; Njala University, Sierra Leone; and the University of Makeni, Sierra Leone.

"Finding Marburg virus in bats in Sierra Leone before any known cases in people is a huge success, as public health officials and doctors can now include Marburg virus among the possible causes when diagnosing hemorrhagic fever cases in the region," said Tracey Goldstein, co-principal investigator and pathogen detection lead for the PREDICT project from the UC Davis One Health Institute.

To date, there have been 12 known outbreaks of Marburg virus, with the most recent in Uganda in 2017. The largest and deadliest outbreak occurred in Angola in 2005 when 227 people died. Five of the new strains identified among the Marburg-positive bats in Sierra Leone were genetically similar to the strain that caused the outbreak in Angola. This is the 1st time scientists have detected these Angolan-like strains in bats.

The virus-positive bats were all Egyptian rousette bats, the known reservoir for Marburg virus, which primarily feed on fruit. Infected bats shed the virus in their saliva, urine, and feces. Egyptian rousette bats are known to test-bite fruits, urinate, and defecate where they eat, potentially contaminating fruit or other food sources consumed by other animals or people, particularly children. These bats sometimes serve as a food source for local populations as well. People may be exposed to Marburg virus through bat bites as they catch the bats.

Following the announcement of the preliminary findings by the government of Sierra Leone, the PREDICT team worked with government partners, universities, and other key stakeholders to develop and implement evidence-based public health messaging across national, district, and local community levels in Sierra Leone. "Over a year ago, we worked with our Sierra Leone government colleagues to inform people across the country as fast as possible of this new health risk and remind people not to harm or come in contact with bats," said Brian Bird from the UC Davis One Health Institute and global lead for Sierra Leone and Multi-Country Ebola operations for PREDICT-USAID. "I'm very proud of that work and our teams now that this full report is available."

[The initial report of this finding, prior to this publication, was posted by ProMED-mail (Marburg virus disease - Sierra Leone (02): bats, additional information http://promedmail.org/post/20181223.6221436) when the virus was detected for the 1st time in fruit bats in Sierra Leone.

According to the CDC (<https://www.cdc.gov/vhf/marburg/index.html>), Marburg virus was 1st recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany, and in Belgrade, Yugoslavia (now Serbia). A total of 31 people became ill, initially laboratory workers followed by several medical personnel and family members who had cared for them; 7 deaths were reported. The 1st people infected had been exposed to imported African green monkeys or their tissues while conducting research. One additional case was diagnosed retrospectively.

The reservoir host of Marburg virus is the African fruit bat, _Rousettus aegyptiacus_. Fruit bats infected with Marburg virus do not show obvious signs of illness. Primates (including humans) can become infected with Marburg virus, and may develop serious disease with high mortality.

Ebola virus is closely related to Marburg virus. "Ebola viral RNA fragments were found in an oral swab from a greater long-fingered bat (_Miniopterus inflatus_), captured in 2016 in Liberia's Sanniquellie-Mahn district, which borders Guinea. The bat, which lives in many parts of Africa, roosts in caves and feeds on insects. Scientists had previously found 2 other Ebola species in a related insect-eating bat, _M. schreibersii_. However, most other evidence has pointed to fruit bats as the carriers of Ebola Zaire, Epstein says [J Epstein, veterinary epidemiologist at EcoHealth Alliance in New York City and a member of the PREDICT consortium]. "What it really says to me is that this is a virus that has multiple hosts, and it might be regionally dependent as to which species carries it."

Supporting the variety of bat hosts for Ebola, the bat implicated in the initiation of the West African Ebola virus outbreak in December 2013 was _Mops condylurus_, long-tailed insect-eating bats, that were previously suspected in an outbreak of the Sudan strain of Ebola virus, which is related to the Zaire strain. - ProMED Mod.LK]

Sierra Leone health officials, supported by WHO, the US Centers for Disease Control and Prevention (CDC), and other partners, are responding to an outbreak of Lassa fever. On 20 Nov 2019, WHO was informed by the Netherlands' International Health Regulations (IHR) National Focal Point of one imported case of Lassa fever from Sierra Leone. The patient was a male doctor, a Dutch national who worked in a rural Masanga hospital in Tonkolili district, Northern province in Sierra Leone.

The probable route of transmission is believed to be through exposures during a surgical procedure he performed on 2 patients in Masanga hospital on 4 Nov 2019. Both patients died following surgical interventions; one died on 4 Nov [2019] and the 2nd on 19 Nov 2019. Both surgical patients are considered probable cases, and the patient who died on 4 Nov [2019] is believed to be the index case for this outbreak, likely the source of infection of the Dutch doctor.

The doctor's symptoms started on 11 Nov [2019], a week after performing the surgery, and included malaise and headache, followed by fever, diarrhoea, vomiting, and cough. While symptomatic, he attended a surgical training event in Freetown, Sierra Leone, on 11-12 Nov [2019]. This event was also attended by several international participants from the Netherlands and United Kingdom in addition to 35 local participants. On 19 Nov [2019], the symptomatic doctor was medically evacuated to the Netherlands after he did not respond to treatment with antimalarials and antibiotics. The evacuation was managed by a dedicated ambulance plane with 4 staff from a German organization. During the journey, the plane stopped in Morocco (Agadir Airport). As the illness was initially thought to be malaria or typhoid fever, personal protective equipment, other than gloves, were not used, and no specific containment procedures were used during the medical evacuation.

Laboratory specimens from the patient tested positive for Lassa fever by polymerase chain reaction (PCR) and sequencing at Erasmus University Medical Centre in Rotterdam on 20 Nov 2019.

The patient died on the night of 23 Nov 2019.

On 22 Nov 2019, WHO was informed of a 2nd laboratory-confirmed case of Lassa fever in another Dutch healthcare worker, who also worked in the Masanga hospital. Samples from this 2nd case were sent to the Erasmus University Medical Centre in Rotterdam and tested positive for Lassa fever by PCR. The 2nd case also participated in one of the surgical procedures performed by the medically evacuated Dutch doctor. The date of onset of symptoms of the 2nd case was 11 Nov [2019]. This case was subsequently medically evacuated in high containment isolation to the Netherlands and is currently under treatment. Isolation precautions have been implemented.

The Masanga hospital in Sierra Leone where the Dutch doctor worked is supported by several non-governmental organizations with international healthcare workers including staff from countries including Denmark, the Netherlands, and the United Kingdom, alongside national healthcare workers.

Contact tracing and monitoring activities have been initiated in these countries as required.

Sierra Leone

An outbreak investigation and response is ongoing under leadership of the Ministry of Health (MoH), supported by CDC and WHO. As of 24 Nov 2019, in addition to the 2 Dutch cases, 2 further cases among national healthcare workers, one confirmed and another suspected, have been reported from Masanga hospital. Both healthcare workers were involved in the management of the 2 surgical patients operated by the Dutch doctor on 4 Nov [2019]. All high-risk contacts in Masanga hospital are being monitored.

The Netherlands

Several high- and low-risk contacts have been identified among personal contacts and healthcare workers. According to Dutch protocols, they will be monitored until 21 days after the last potential exposure. Five high-risk Dutch contacts who were in Sierra Leone have been repatriated through a dedicated flight and are now under monitoring. Dutch low-risk contacts in Sierra Leone have been advised to perform self-monitoring in situ.

Germany

The 4 medical evacuation flight staff (2 pilots and 2 healthcare workers) spent 8 flight hours in a confined space in the ambulance plane without any barrier between the cockpit and cabin. They have been assessed as moderate-risk contacts. According to German recommendations, they are being monitored for 21 days following the last potential exposure on 19 Nov (until 10 Dec 2019).

United Kingdom (UK)

UK authorities have identified 18 UK nationals as contacts of the 1st Dutch case. Of these 18, 8 are high-risk contacts and were exposed in Masanga hospital while working alongside the doctor or may have been exposed to the 2 patients he operated on 4 Nov [2019]. Of these 8 high-risk contacts, 7 returned to the UK and one went to Uganda. In addition, 13 UK nationals attended a surgical training event in Freetown, Sierra Leone, on 11-12 Nov [2019], which was also attended by the 1st Dutch case while already symptomatic. Of these 13 participants, 3 came from Masanga hospital and belong to the above group of 8 high-risk contacts. The remaining 10 participants were possibly exposed during the training and are considered low-risk contacts. Of these 18 contacts identified (8 high-risk and 10 low-risk contacts), 17 have returned to the UK and are under public health follow-up for 21 days; one high-risk contact went to Uganda. There were also several Dutch and 35 local participants who attended this event. UK authorities are in contact with the organizers, and the names of participants from Sierra Leone and the Netherlands have been shared with respective National IHR Focal Points.

Uganda

One contact, a UK national, who may have been exposed in Masanga hospital on 15 Nov [2019] and subsequently travelled to Uganda on 16 Nov [2019], is now being followed up by the Uganda authorities, and the UK authorities are providing support remotely though public health and consular channels.

The National IHR Focal Point of the Netherlands has also informed their counterpart in Morocco about the potential risk of exposure at the Agadir Airport. Morocco National IHR Focal Point confirmed that the investigation is conducted, and control measures have been implemented to ensure there was no transmission in Agadir.

Sierra Leone is endemic for Lassa fever. Previously, sporadic cases have been exported to Europe from endemic countries in Africa, such as Togo, Liberia and Nigeria. In 2018, a total of 23 confirmed Lassa fever cases with 14 deaths (case fatality rate 61%) were reported from 2 districts of Sierra Leone: Bo district (2 cases; 2 deaths) and Kenema district (21 cases; 12 deaths).

From 1 Jan-17 Nov 2019, of the 182 suspected cases, 10 cases with 6 deaths (case fatality ratio 60%) have been confirmed for Lassa virus infection. All confirmed cases during this period were reported from Kenema district, which has been reporting cases of Lassa fever every year.

Public health response

The International Health Regulations Focal Points and Health Authorities in Denmark, Germany, Morocco, the Netherlands, Sierra Leone, Uganda, and the UK have been collaborating to share information about this event, together with the WHO and US CDC. Contact tracing and monitoring activities for 21 days following the last potential exposure have been initiated in Sierra Leone, Germany, the Netherlands, Uganda, and the UK. Investigations are ongoing in Sierra Leone in Masanga hospital and surrounding areas in Tonkolili district with a deployment of a national rapid-response team, supported by US CDC and WHO.

WHO risk assessment

Lassa fever is an acute viral haemorrhagic fever illness that is transmitted to humans via contact with food or household items contaminated with rodent urine or faeces. Human-to-human infections and laboratory transmission can also occur through direct contact with the blood, urine, faeces, or other bodily secretions of a person with Lassa fever. The overall case fatality rate is 1%; it is 15% among patients hospitalized with severe illness.

Sierra Leone is endemic for Lassa fever, and sporadic cases have been exported to Europe from endemic countries in Africa, such as Togo, Liberia and Nigeria in recent years. However, in general, the secondary transmission of Lassa fever through human contacts is rare.

Data from recent imported cases show that secondary transmission of Lassa fever is rare when standard infection-control precautions are observed. Further, epidemiological investigations are ongoing: human-to-human transmission occurs in both community and healthcare settings, where the virus may spread by contaminated medical equipment. Healthcare workers are at risk if caring for Lassa fever patients in the absence of appropriate infection prevention and control measures. Considering the seasonal flare-ups of cases in humid zones between December and March, countries in West Africa that are endemic for Lassa fever are encouraged to strengthen their related surveillance systems.

WHO advice

Prevention of Lassa fever relies on community engagement and promoting hygienic conditions to discourage rodents from entering homes. There is currently no approved vaccine. Early supportive care with rehydration and symptomatic treatment improves survival. Family members and healthcare workers should always be careful to avoid contact with blood and body fluids while caring for sick persons.

According to WHO guidance for viral haemorrhagic fever, healthcare staff should consistently implement standard precautions when caring for all patients to prevent infections acquired in a healthcare setting and strictly apply contact precautions, including isolation, when caring for suspected or confirmed Lassa fever patients or handling their clinical specimens or body fluids. Standard precautions are meant to reduce the risk of transmission of bloodborne and other pathogens from both recognized and unrecognized sources. Standard precautions are recommended in the care and treatment of all patients regardless of their perceived or confirmed infectious status. They represent the basic fundamental level of infection prevention and control and include hand hygiene, use of personal protective equipment to avoid direct contact with blood and body fluids, prevention of needle stick and injuries from other sharp instruments, and a set of environmental controls. Sterilization and environmental cleaning should also be particularly strengthened and undergo quality control assessments.

In order to avoid any direct contact with blood and body fluids and/or splashes onto facial mucosa (eyes, nose, mouth) when providing direct care for a patient with suspected or confirmed Lassa virus, personal protective equipment should include

1) clean non-sterile gloves,

2) a clean, non-sterile fluid-resistant gown, and

3) protection of facial mucosa against splashes (mask and eye protection, or a face shield).

Given the nonspecific presentation of viral haemorrhagic fevers, isolation of ill travellers and consistent implementation of standard precautions are key to preventing secondary transmission. When consistently applied, these measures can prevent secondary transmission even if travel history information is not obtained, not immediately available, or the diagnosis of a viral haemorrhagic fever is delayed.

WHO continues to advise all countries in the Lassa fever belt due to the need to enhance early detection and treatment of cases to reduce the case fatality rate as well as strengthen cross-border collaboration. WHO advises against any restrictions on travel or trade to or from Sierra Leone based on the current available information.

======================

[The above report provides the details and timelines related to the 2 confirmed cases of the Dutch physicians and the many suspected contacts. The 2 confirmed cases illustrate the difficulty in identifying Lassa fever cases when the infected individuals are early in the course of the disease so that barriers to transmission of the virus can be implemented. The 1st Dutch physician initially was thought to have malaria or typhoid fever, diseases more common in the area than Lassa fever. It will be interesting to learn if any of the contact individuals in the UK, Germany, or Uganda become infected. - ProMED Mod.TY]

Cayman Islands

COUNTRY DESCRIPTION:The Cayman Islands are a British dependent territory consisting of three main islands with a total area of approximately 100 square miles and located a
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out 500 miles west of Jamaica. There is an international airport located in Grand Cayman, and facilities for tourists are widely available. The U.S. Embassy in Kingston, Jamaica, has consular responsibility for the Cayman Islands. Read the Department of State Background Notes on the Cayman Islands for additional information.

ENTRY/EXIT REQUIREMENTS: All Americans traveling by air outside of the United States are required to present a passport or other valid travel document to enter or re-enter the United States. This requirement will be extended to sea travel (except closed-loop cruises), including ferry service, by the summer of 2009. Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other Western Hemisphere Travel Initiative (WHTI) compliant document such as a passport card for entry or re-entry to the U.S. Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements. Applications for the new U.S. Passport Card are now being accepted and have been in full production since July 2008.The card may not be used to travel by air and is available only to U.S. citizens. Further information on passport cards is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html. We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel. American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports. Visas are not required for U.S. citizens traveling to the Cayman Islands for short-term visits. U.S. citizens traveling to the Cayman Islands for work must obtain a temporary work permit from the Department of Immigration of the Cayman Islands, telephone (345) 949-8344. There is a departure tax for travelers age 12 and older, which is regularly included in airfare. For further information travelers may contact Cayman Islands Department of Tourism offices in Miami at (305) 599-9033, New York (212) 889-9009, Houston (713) 461-1317 and Chicago (630) 705-0650; or via the Internet at http://www.caymanislands.ky.

Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet. SAFETY AND SECURITY:The Cayman Islands are considered politically stable and enjoy a high standard of living. There have been no reported incidences of terrorism or threats made against Americans or American interests in the Cayman Islands.For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Public Announcements, including the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for other callers, a regular toll line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphletA Safe Trip Abroad. CRIME: The crime threat in Cayman Islands is generally considered low, although travelers should always take normal precautions when in unfamiliar surroundings. Petty theft, pick-pocketing and purse snatchings occur. A few cases involving sexual assault have been reported to the Embassy. Police in the Cayman Islands rigorously enforce laws against illegal drugs. The majority of arrests of American citizens in the Cayman Islands over the past two years have been for possession, consumption, or intent to sell marijuana, cocaine or other illicit drugs. American citizens should avoid buying, selling, holding or taking illegal drugs under any circumstances. INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in the Cayman Islands is “911.” See our information on Victims of Crime. MEDICAL FACILITIES AND HEALTH INFORMATION: The quality of medical care in the Cayman Islands is generally comparable to that available in the United States; however, some procedures and cases requiring critical care may require medical evacuation to the United States. Several American citizens each year drown or suffer cardiac arrest while snorkeling or scuba diving in the Cayman Islands. These deaths may be attributed in part to tourists attempting to do more than they are trained to do or to poor physical conditioning or preexisting medical conditions that are exacerbated when snorkeling or diving. A hyperbaric chamber is available for treatment of decompression illness. Doctors and hospitals often expect immediate payment for health services. Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.

Although there are no express HIV/AIDS entry restrictions exist for visitors to the Cayman Islands, persons suffering from HIV/AIDS can be denied permission to land if a Health Officer certifies that their entry to the Islands would be dangerous to the community pursuant to Section 82 (c) of the Cayman Immigration Law (2007 Revision), which states:

“The following persons, not being Caymanian or permanent residents, are prohibited immigrants – a person certified by a Health Officer to be suffering from a communicable disease that makes his entry into the Islands dangerous to the community.” MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning the Cayman Islands is provided for general reference only, and may not be totally accurate in a particular location or circumstance. As in Great Britain and its other colonies, vehicles in the Cayman Islands travel on the left-hand side of the road (the opposite side compared with driving in the United States). Due to their size, the Caymans have little highway infrastructure to maintain. Local driving standards, the risk of accidents, the availability of emergency roadside service, quality and frequency of signage, and enforcement of traffic laws, generally meet the standards of the United States. Visitors must obtain a temporary driver's license, easily granted upon presentation of a valid state driver's license and payment of a small fee, at a car rental agency or a police station. Laws against driving while intoxicated are strictly enforced, with a legal maximum blood alcohol level set at 100 milligrams per 100 milliliters of blood. Seatbelt laws are also enforced and require the driver and all passengers to wear seatbelts while in motion. Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office at www.caymanislands.ky AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of the Cayman Islands’ Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the Cayman Islands’ air carrier operations. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:Cayman Islands customs authorities may enforce strict regulations concerning temporary importation into or export from the Cayman Islands of items such as firearms of any kind, spear guns (or pole spears or Hawaiian slings), live plants and plant cuttings. Raw fruits and vegetables are also restricted. Visitors from the United States should be aware that products made from farmed green sea turtles at the Cayman Turtle Farm Ltd. are offered for local consumption; however, the importation of genuine sea turtle products is strictly prohibited by the United States, as well as other countries that have signed the Convention on International Trade in Endangered Species. In addition, U.S. Customs prohibits the transshipment of turtle products through the United States and any products discovered will be confiscated. It is advisable to contact the Collector of Customs (345) 949-2473 for specific information regarding customs requirements. Please see our Customs Information.

The Cayman Islands, like all Caribbean countries, can be affected by hurricanes. Hurricane season runs from June 1 to November 30 each year. The Office of Disaster Preparedness and Emergency Management (ODPEM) has put measures in place in the event of an emergency or disaster. General information is available on the subject via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating the Cayman Islands’ laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in the Cayman Islands are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction. REGISTRATION / EMBASSY LOCATION:Americans living or traveling in the Cayman Islands are encouraged to register with the U.S. Embassy in Kingston, Jamaica through the State Department's travel registration web site, and to obtain updated information on travel and security within the Cayman Islands. Americans without Internet access may register directly with the U.S. Consular Agency in George Town, Grand Cayman or the U.S. Embassy in Kingston, Jamaica. By registering, American citizens make it easier for the Embassy or Consular Agency to contact them in case of emergency. The U.S. Consular Agency in the Cayman Islands is located at 222 Mirco Center, North Sound Road, Georgetown, Grand Cayman. Its phone number is (345) 945-8173. Office hours are Monday, Wednesday, and Friday from 08:00 a.m. to 2:00 p.m.

American citizens requiring assistance in Cayman may also contact the American Citizen Services Unit of the U.S. Embassy in Kingston, Jamaica at (876) 702-6000. The Consular Section of the U.S. Embassy is located at 142 Old Hope Road,, Kingston 6. Office hours are Monday through Friday (except Jamaican and U.S. holidays), 7:15 a.m. to 4:00 p.m., with window services 8:30 to 11:30 a.m. Both the Consular Agency and Embassy may provide updated information on travel and security within the Cayman Islands. The Embassy web site is http://kingston.usembassy.gov/* * *This replaces the Country Specific Information for the Cayman Islands dated December 3, 2007, to update sections on entry/exit requirements, crime, and medical facilities.

An outbreak of hand-foot-mouth disease that surfaced a few weeks ago is still affecting some schools on Grand Cayman.

The disease is not uncommon on the island and typically affects children under 10 and especially those aged 5 and younger. Children with the virus typically have a fever, sore throat, a red rash on the palms of the hands and soles of the feet, mouth sores, and loss of appetite. There is no specific treatment other than to let the illness run its course. The best prevention is practicing good sanitation and hygiene.

Tim McLaughlin, an epidemiologist with the Public Health department, said the 14 cases reported from 4-10 Feb 2018 were the most he has seen in a single week. Figures for last week [week of 12 Feb 2018] are not yet available, but Mr McLaughlin said it looked as though the spread of the disease had slowed down. Most children were out of school last week and that may be a factor, he said

"14 in a week is a lot," Mr. McLaughlin said. "It also tells me there are more cases out there."

As a consequence, he said, he is more closely monitoring the spread of the disease, which is not uncommon this time of year. If need be, he said, "We'll sound the alarm."

At the Department of Education Services, director Lyneth Monteith said she was unaware of any public schools currently being affected by the disease. But preschools are seeing the problem.

Bri Bergstrom, the owner of the Montessori School of Cayman, said 3 of her students came down with the illness 3.5 weeks ago. It was the 1st such outbreak at the school, she said, adding that no other students have since been affected.

"It seems to be going around," Ms Bergstrom said. "It's almost impossible to avoid sometimes, things coming into the school."

She and others operating schools and preschools said that they have increased their efforts to keep classrooms and play areas sanitary by cleaning more often and doing thorough deep cleaning.

"Even when the flu is going around, we always amp up the sanitation," Ms Bergstrom said.

At the Treasure Garden, a preschool with 35 students, teacher Tonie-Ann Broomfield said 6 pupils have contracted the disease over the past 2-3 weeks. Some of the students, she said, showed no outward symptoms, such as a fever, before breaking out in a rash. She said the staff is being more vigilant.

"As soon as we check their temperature and it's above 100 deg F [37.8 deg F], we call the parents and ask them to take them to the doctor," Ms Broomfield said, adding that the child is kept isolated from other children until they are picked up. [Byline: Mark Muckenfuss]

========================

[Hand-foot-mouth disease is caused by viruses that belong to the _Enterovirus_ genus (group), which includes polioviruses, coxsackieviruses, echoviruses, and other enteroviruses. - Coxsackievirus A16 is typically the most common cause of hand-foot-mouth disease in the United States, but other coxsackieviruses can also cause the illness. - Enterovirus 71 has also been associated with cases and outbreaks (<https://www.cdc.gov/hand-foot-mouth/outbreaks.html>) of hand-foot-mouth disease, mostly in children in East and Southeast Asia. Less often, enterovirus 71 has been associated with severe disease, such as encephalitis. - Several types of enteroviruses may be identified in outbreaks of hand-foot-mouth disease, but most of the time, only 1 or 2 enteroviruses are identified.

Generally, a person with hand-foot-mouth disease is most contagious during the 1st week of illness. People can sometimes be contagious for days or weeks after symptoms go away. Some people, especially adults, may become infected and not develop any symptoms, but they can still spread the virus to others. This is why people should always try to maintain good hygiene, such as frequent handwashing, so they can minimize their chance of spreading or getting infections. (Excerpted and edited from <https://www.cdc.gov/hand-foot-mouth/about/transmission.html>). - ProMED Mod.LK]

The [Cayman Islands] Public Health Department is issuing an alert for travellers after at least 2 cases of measles were confirmed in the Caribbean and Central America that appear to have been imported from Europe. There have been no cases of measles in the Cayman Islands since 1990. Local immunisation coverage against the disease is around 90% among 15-month-old children and about 97% by the time they reach school age. But officials are urging anyone who becomes unwell after returning from the UK and Europe as well as parts of the US to visit a doctor.

People who are experiencing a sudden high fever accompanied by a rash should seek medical attention immediately and provide their travel history to the doctor for necessary investigation.

"If you are travelling to any of the affected areas where measles has been confirmed, safeguard yourself and your family by ensuring that your and your children's immunisations against measles are up to date," advised Nurse Angela Graham, manager of the Health Services Authority's Expanded Programme on Immunisation. "Unprotected children are at the greatest risk of contracting this virus, should a case be imported to the Cayman Islands. It is the responsibility of parents and guardians, alike, to ensure that their children are protected."

Dr Samuel Williams-Rodriguez, Acting Medical Officer of Health, said that while there has been great progress in the fight against measles regionally, there is a risk of spread and sustained transmission in areas with susceptible populations.

"Vaccination with at least 2 doses remains the most effective measure," he said. "I emphasise that measles can be reintroduced as we have many residents and visitors travelling to and from the Americas and European countries. We should therefore remain vigilant."

He added, "The 1st sign of measles is usually a high fever which begins about 10-12 days after exposure to the virus. A runny nose, cough, along with red and watery eyes and small white spots inside the cheeks, can develop in the initial stage followed by a rash on the face and upper neck, eventually reaching the hands and feet."

Measles is caused by a virus which grows in the cells that line the back of the throat and lungs. It is a human disease and is not known to occur in animals. Close contact with other people following the onset of rash must be avoided 7 for days.

For complete protection, children older than 12 months should have 2 doses of MMR (measles mumps and rubella) vaccine. Children between 6 and 11-months, who are travelling abroad, are recommended to have one dose of MMR vaccine.

More than 400 feral chickens in Bodden Town have died of botulism, according to a post-mortem examination carried out by the Department of Agriculture. The birds began dying more than 2 weeks ago, residents in the area said. Brian Crichlow of the Department of Agriculture said a post-mortem exam on one of the birds revealed botulism. The bird was also tested for avian flu, with negative results. Mr Crichlow said botulism is not spread by direct contact with affected chickens, but there is a "low potential for spreading to humans and other animals through consumption of dead chickens" contaminated with the botulism toxin.

Botulism is a micro-organism that occurs naturally in the soil and in decaying flesh. Since chickens are scavengers, they likely ate a dead animal and got sick, said Mr. Crichlow.

The Department of Environmental Health was expected to begin removing the birds from the site, near the Bodden Town Mission House, on Wednesday afternoon [16 Apr 2014], according to the department's director, Roydell Carter. "We are aware of the situation. We were notified by the Department of Agriculture about it. We went on site today [Wed 16 Apr 2014] and we will be assisting them in getting the birds removed and disinfecting the area," he said. "We're putting together the resources we need -- there are so many [dead chickens] all over the place ... We will go in and help. There could probably be public health implications as well [if the carcasses are not removed]. We don't want all these dead birds lying around ... where other animals might feed on their carcasses," he added.

On Wednesday [16 Apr 2014], many of the dead chickens could be seen around the Mission House and Harry McCoy Park, and under the home of an elderly couple nearby. Mr Crichlow advised that if the dead or dying birds are not removed and disposed of properly, other chickens will feed on the carcasses and the maggots from the dead chickens, leading to more chickens contracting botulism. Botulism is also known as "limberneck," he said, reflecting the neck paralysis typically seen in affected birds. [The son] of the couple under whose home many of the decaying carcasses were seen, said he had picked up as many as he could, but those under the house would have to stay there until he had help removing them.

"The chickens just get crippled, lie down and die," said [the man], who often fed the chickens. For the past 2 weeks, the chickens have been "dropping off like flies," he said.

The feral chickens roam the neighborhood and are considered pests by many in the area. Mr Crichlow said there had been no reports of domestic flocks of chickens owned by local farmers being affected by botulism. However, he said the department had seen similar episodes before of local wild chickens dying, adding that botulism is common in feral chickens in Cayman and elsewhere. Over the past 2 years, his department has responded to deaths of feral chickens in George Town, West Bay and Bodden Town districts, he said.

Karen Rosenthal, a St. Matthews Veterinary School veterinarian who studies birds, said, "It is not so easy for people to get botulism the same way chickens do. But you would never eat the eggs or meat from a chicken with botulism," she said. "What we should worry about is if the people are using the same water source as the dead birds."

Kiran Kumar, medical officer of health at the public health department, said botulism from dead chickens does not spread to human beings through the air, and there is also no evidence of it spreading to humans by consumption of chickens with botulism. However, he advised against eating infected chickens to "prevent any rarest possibility of such occurrence." [Byline: Jewel Levy]========================[Avian botulism is much more often seen in wild ducks and other water birds. But we do have a prior report of an Australian incident which is very similar to this Cayman report. The Australians ascribed it to a buildup of the causative organism, _Clostridium botulinum_, in the soil. - ProMed Mod.MHJ]

The 1st known outbreak of the chikungunya virus in the western hemisphere has Caribbean governments working to prevent the disease from spreading and damaging the region's tourism-dependent economies.

About 280 cases of chikungunya [virus infection; many more cases than this, see other reports - ProMed Mod.TY], which can cause severe joint pain, fever and headaches, have been reported since early December [2013] in Dutch and French Saint Martin, Saint Barthelemy, Martinique, Guadeloupe, Dominica, the British Virgin Islands, and French Guiana. Officials from Venezuela to the Cayman Islands have warned of the potential for the mosquitoborne virus, 1st identified from a patient in Tanzania in 1953, to spread. There is no treatment, and the illness is rarely fatal.

"The worst case scenario would be that the impact would be significant and slow down the whole economy in the Caribbean," James Hospedales, the executive director of the Caribbean Public Health Agency, said by telephone. "The Caribbean is the most tourism-dependent region in the world, so if it spreads like wildfire you could scare away tourists." [byline: Isabella Cota and Elizabeth Lopatto]=====================[This report is a good illustration of potential adverse economic effects when a new disease appears in a major tourist destination. Although dengue fever poses greater health risks, the addition of a 2nd virus disease to the area increases concern on the part of the traveling public. - ProMed Mod. TY]

The Cayman Islands Mosquito Research and Control Unit and Oxitec have cited an 80 per cent reduction in the numbers of _Aedes aegypti_ mosquitoes in Grand Cayman after introducing genetically modified mosquitoes into the environment as a control measure. This finding, which was officially published in a report in Nature Biotechnology, was previously reported in the 17 Jan 2012 edition of the Caymanian Compass.

One of the main reasons the report said led to the Cayman Islands "having a need the need for alternative measures of control" was the high level of resistance to insecticide shown by _Aedes aegypti_ mosquitoes in Grand Cayman. The report references research done by MRCU Entomologist Angela Harris and Hilary Ranson of the Liverpool School of Tropical Medicine, who in their findings, "Pyrethroid Resistance in Aedes Aegypti," stated: "The Grand Cayman population of _Aedes aegypti_ is highly resistant to DDT and pyrethroid insecticides."

In an interview with the Caymanian Compass, Dr. Harris said, "For our experiments regarding the issue of resistance to insecticides we used mosquitoes that have been in a secure environment for over 30 years in a colony that was bred repeatedly over time and then compared those with the mosquitoes from the Grand Cayman. The results indicated that those found here are much more resistant and could be exposed to DDT for up to 8 hours."

Ms Harris added that the _Aedes aegypti_ mosquito has only been in the Cayman Islands since 2002 and could have likely acquired its resistance from its places of origin, which have not been determined. She also surmised that their resistance level could be as a result of cross-resistance from a pyrethroid resistance. In any event, much of Dr. Harris' research going forward will be to substantiate the theory that the mosquitoes came to the Cayman Islands with the resistance as opposed to developing it here. The Cayman Islands has never used DDT in its mosquito control efforts.

However, the Mosquito Research and Control Unit of the Cayman Islands was scrutinised in the foreign press for using genetically modified _Aedes aegypti_ mosquitoes to combat the spread of dengue fever. It was the 1st time the method was being used in a real world test area.

At the time, Bill Petrie, director of MRCU, said the initiative was essentially a new spin on an old technique in which males that were made sterile were released. He added that the difference here is that the male mosquitoes' genes were altered, as opposed to their sterility being chemically induced by radiation.

"MRCU along with Oxitec of Oxford University ran the trial for 6 months," Mr. Petrie said. "We chose a small isolated area in East End. This was done in 3 blocks; one block was where the method was introduced, while nothing was done in another block and the 3rd block was used to monitor the natural population of the _Aedes aegypti_ mosquito.

"Once the team perfected the technique, monitoring was done by traps. The final statistical analysis has shown a significant reduction in the population of this potential dengue carrier," he added.

Mr. Petrie said the male _Aedes aegypti_ mosquito cannot bite and lives a short life-span and since their eggs will not survive using this new method of control, the population of the species has decreased, as did the probability of dengue fever transmission. Since the Cayman Islands' success using the genetic modification technique, several other jurisdictions are following suit.

"Dengue is a dangerous and debilitating disease, which affects up to 100 million people each year. The incidence of dengue has grown very rapidly in recent years: it is now a serious threat to global health, and the only means of prevention is to target the mosquitoes which carry it. We need new tools in the fight against these dangerous pests, and today's publication shows that Oxitec's approach can provide that," Mr. Petrie said. [Byline: Stuart Wilson]======================Reference:

[This is an interesting field experiment that produced an 80 per cent reduction in the _Aedes aegypti_ population through release of genetically modified mosquitoes into a population of native mosquitoes resistant to 2 common pesticides. The release of genetically modified mosquitoes will be considered controversial and opposed by some, but alternatives such as increasing use of pesticidal chemicals have been of limited success in medium- to long-term vector population reduction efforts. It will be interesting to see how successful the release of these genetically modified mosquitoes will be in other locations. An effective, commercially available dengue virus vaccine is still several years away. Meanwhile, vector control is the only way to prevent dengue virus transmission. - ProMed Mod.TY]

[A HealthMap/ProMED-mail map showing the location of the Cayman Islands in the Caribbean can be accessed at: http://healthmap.org/r/1IG3.]

American Samoa

Samoa US Consular Information SheetJanuary 23, 2008 COUNTRY DESCRIPTION:Samoa consists of the two large islands of Upolu and Savai’i and seven small islets. The country has a stable parliamentary democracy with a developing economy. To
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rist facilities are accessible by bus, taxi and car and are within walking distance of access roads. Infrastructure is adequate in Apia, the capital, but it is limited in other areas. Nearly all Internet connections use a relatively slow dial-up method. Samoa has two digital telephone service providers, and visitors can easily purchase prepaid phones that cover virtually the entire country. The Samoa Tourism Authority, at http://www.visitsamoa.ws/, provides a wide range of information of interest to travelers. Read the Department of State Background Notes on Samoa for additional information.

ENTRY/EXIT REQUIREMENTS:U.S. nationals who are not U.S. citizens, and who are resident in American Samoa, must obtain a visitor permit prior to all travel to Samoa. U.S. nationals have not been permitted to travel to Samoa on certificates of identity since May 2005 except on a case by case basis. (U.S. law distinguishes between individuals who are citizens and those who are nationals. The U.S. passport bio-page shows one’s status as either a citizen or a non-citizen national.) As of March 22, 2006, visitor permits to travel to Samoa can be applied for at the new Samoa Consulate General office in Pago Pago, American Samoa. A valid passport and an onward/return ticket are required for all Americans (both citizens and nationals) to travel to Samoa. Visitor permits are not required for U.S. citizens (only for U.S. nationals) seeking to stay in Samoa for up to 60 days. All visitors are required to pay a departure tax of 40 Tala (approximately 17.50 USD) upon leaving the country. Further information about entry requirements and the departure tax may be obtained from the Samoa Mission to the United Nations at 800-2nd Avenue, Suite 400J, New York, NY 10017, telephone (212) 599-6196, fax (212) 599-0797. Visit the Embassy ofSamoa web site at http://www2.un.int/public/Samoa/ for the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:In Apia and many villages, stray dogs wander the streets. Visitors should not approach or feed them; they can become aggressive in the presence of food or if they feel threatened.

Although there have been no major accidents involving the ferry service linking Upolu and Savai’i, vessels are sometimes overloaded. One of the ferries, a multi-deck automobile ferry, sometimes transports passengers on its automobile deck. Americans who choose to use this ferry are encouraged not to remain in the automobile deck during the crossing and to ride only in the passenger compartment in order to avoid injury from shifting vehicles.

Samoa has numerous “blowholes” (lava tubes open to the sea where wave action produces, often spectacular, geysers). These blowholes are popular tourist attractions. The footing around the mouths of most blowholes is very slippery. To avoid being swept in, visitors should not approach too closely and should never stand between the opening of the blowhole and the sea.

Snorkeling and diving in ocean lagoons is a popular activity for many visitors to Samoa. Tide changes can produce powerful currents in these lagoons. Visitors are encouraged to consult local residents and tour operators about hazards and conditions at a particular location before venturing into the water.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME:Overall, Samoa is considered a low threat environment. Nevertheless, visitors should remain aware of their surroundings, lock their doors at night, and not leave their belongings unattended. Incidents of petty theft/robberies of personal effects are common. Some such incidents have involved residential break-ins. While rare, violent assaults, including sexual assaults have occurred in Samoa. No specific groups have been targeted, nor have there been any racially motivated or hate crimes against Americans. Police responsiveness in Apia is generally good. Because of the very limited police presence elsewhere in Samoa (where order is maintained primarily by local village authorities), police responsiveness elsewhere is problematic.

INFORMATION FOR VICTIMS OF CRIME:The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:Health care facilities in Samoa are adequate for routine medical treatment, but are limited in range and availability; complex illnesses and life-threatening emergencies generally need to be treated elsewhere. Dental facilities do not meet U.S. standards, but good dental treatment and some emergency care can be obtained nearby at the LBJ Tropical Medical Center in Pago Pago, American Samoa. The national hospital and a small private hospital are located in Apia, and there are several small district hospitals on Savai'i and in outlying areas of Upolu. There are no hyperbaric chambers on any of the islands for the treatment of scuba diving related injuries. Serious cases of decompression sickness are evacuated to the nearest treatment center in Suva, Fiji, or Auckland, New Zealand. Serious medical conditions and treatments that require hospitalization and/or medical evacuation to the United States can cost thousands of dollars. Travelers should carry emergency evacuation insurance. Doctors and hospitals often expect immediate cash payment for health services. There is no reported incidence of malaria or rabies in Samoa. Occasional outbreaks of typhoid and non-hemorrhagic dengue do occur.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.

MEDICAL INSURANCE:The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Samoa is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Safety of public transportation and rural road conditions in Samoa, are considered fair, while urban road conditions/maintenance is considered good. Taxis in particular are widely available and used by Samoans and visitors alike; buses are slow, generally crowded and uncomfortable, and rarely utilized by visitors. Rental cars can also be obtained. No roadside assistance is available. Most major roads are tar-sealed, but secondary roads are predominantly dirt and gravel and may be overgrown with vegetation. A four-wheel drive vehicle is recommended for travel on these roads. Travelers should be aware that vehicle safety regulations are rarely enforced and traffic violations occur routinely. Roads outside Apia are often narrow, winding, relatively steep, with narrow or no shoulders, and poorly lighted. Pedestrians as well as vehicles and livestock regularly travel these roads. Due to poor and deteriorating road conditions, night driving on unlit rural roads can be dangerous and should be avoided if possible. Roads in Samoa often traverse small streams. Drivers are urged to exercise extreme caution when fording these streams, which can become swollen and dangerous with little warning. Vehicles should never enter a stream if the roadbed is not visible or if the water’s depth exceeds the vehicle’s clearance.

Speed limits in Samoa are 25 miles per hour in the Apia area and 35 miles per hour outside Apia, with certain exceptions. At unmarked intersections, traffic on the left has the right of way. As in the United States, vehicular traffic moves on the right side of the road; although right-hand-drive vehicles (mainly from New Zealand) do exist in Samoa. Importing right hand drive vehicles to Samoa is currently legally forbidden.

Please refer to our Road Safety page for more information. Visit the web site of the country’s national tourist office at Samoa Tourism Authority at http://www.visitsamoa.ws/.

AVIATION SAFETY OVERSIGHT:The U.S. Federal Aviation Administration (FAA) has assessed the Government ofSamoa’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Samoa’s air carrier operations. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:Some overseas treatment centers, known as Behavior Modification Facilities, operate in Samoa. Though these facilities may be operated and staffed by U.S. citizens, the Samoan government is solely responsible for compliance with local safety, health, sanitation and educational laws and regulations, including all licensing requirements of the staff in country. These standards, if any, may not be strictly enforced or meet the standards of similar facilities in the U.S. Parents should be aware that U.S. citizens and non-citizen nationals 14 years of age and older have a right to apply for a passport and to request repatriation assistance from the U.S. government, both without parental consent. Any U.S. citizen or non-citizen enrollee has the right to contact a representative from the U.S. Embassy. For further information, consult the Department of State's Fact Sheet on Behavior Modification Facilities, available via the Bureau of Consular Affairs home page. Parents may also contact the U.S. Embassy in Apia or the country officer in the Office of American Citizens Services, Bureau of Consular Affairs at 202-647-5226.

Financial Transactions:Although some businesses (especially those in Apia or those frequented by tourists) do accept credit cards, many (including gas stations) do not. Major credit cards (Visa, Master Card, and American Express) are accepted at major hotels and some restaurants and stores. Samoan currency can be obtained from ATMs, which are located in Faleolo Airport and in many locations in Apia. For more information on ATM locations and banking services see ANZ web site at http://www.anz.com/samoa/overview.asp and WESTPAC web site at http://www.westpac.com.ws/pacific/publish.nsf/Content/PFSA+HomePage.

Disaster Preparedness: Samoa is located in an area of high seismic activity. Although the probability that a major earthquake would occur during an individual trip is remote, earthquakes can and will continue to happen. Major cyclones have occurred in the past and are always a concern. Strong winds and very heavy rains are common, especially during the rainy season from November to April. During this period, Samoa receives most of its annual average of over 130 inches of rain. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency’s (FEMA) web site at http://www.fema.gov/.

Customs: Samoa customs authorities may enforce strict regulations concerning temporary importation into or export from Samoa of items such as firearms, fruits, pets and other animals, and drugs. It is advisable to contact the Samoan Mission to the United Nations at 800 2nd Avenue, Suite 400J, New York, NY 10017, telephone (212) 599-6196 for specific information regarding customs requirements. Please see our Customs Information.

CRIMINAL PENALTIES:While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Samoa’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Samoa are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:Samoa is not a member of the Hague Convention on the Civil Aspects of International Child Abduction. For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION/EMBASSY LOCATION:Americans living or traveling in Samoa are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security withinSamoa. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located in the Accident Compensation Board (ACB) Building, Fifth Floor, Apia. The Embassy is open to the public from 8:15 a.m. to 5:00 p.m. Monday - Friday. The Embassy's mailing address is U.S. Embassy, P.O. Box 3430, Apia, Samoa 0815. The telephone numbers are (685) 21436/21631/22696 and 21452. The fax number is (685) 22030. An Embassy officer can be reached after hours in an emergency involving the welfare of a U.S. citizen or non-citizen national at (685) 21514 or (685) 777-1776. Visit the U.S. Embassy’s web site at http://samoa.usembassy.gov/.* * *This replaces the Consular Information Sheet (now known as Country Specific Information) dated May 21, 2007, to update sections on Country Description and Crime.

American Samoan authorities continue to report cases of Chikungunya as now numbers reach 626
Disease Chikungunya Virus American Samoa
- 6 years ago

Latest figures from Samoa's Ministry of Health show an increase of suspected and confirmed cases of chikungunya [virus infections] from 400 to 626 since the outbreak of the acute fever, rash and joint pain disease was reported in July [2014].

However, the ministry says so far presentation of the main signs and symptoms of those affected have largely been mild.

The highest number of people affected is recorded in the districts of Vaimauga west in the urban area with 151 cases; Faleata east, 139 cases; and 113 in Faleata west. The majority of patients is young.

In American Samoa, the chikungunya outbreak is on the wane. Health officials say there are now 823 probable cases of the mosquito-borne illness, with 15 people requiring hospital care.===========[The chikungunya outbreak continues to grow in Samoa, from 269 cases reported on 25 Aug 2014 to 433 reported on 8 Sep 2014 and now to 626 cases. One hopes that a prompt and aggressive clean up of breeding sites will reduce the vector mosquito population enough to halt, or at least reduce, transmission.

On 26 Jul 2014, it was reported that American Samoa had about 100 cases, with 3 laboratory confirmed as chikungunya virus infections (see ProMED-mail archive no. 20140727.2638925). This is a sharp outbreak, with over 700 cases in a little over one month, apparently peaking at 823 probable cases reported above. Once introduced into American Samoa, spread of the virus is not surprising, because it has had dengue virus transmission in the past, and the same mosquitoes that transmit dengue viruses can transmit chikungunya virus as well.

Now over 700 cases of Chikungunya reported in American Samoa
Disease Chikungunya Virus American Samoa
- 6 years ago

The latest reports from American Samoa reveal that chikungunya-related [febrile] cases have now reached over 700, and there is now one probable case in Ofu, Manua. The virus was discovered in the territory in July 2014, but there have been no reported cases in Manua until now.

Health officials are urging residents not to travel to Manua if they have chikungunya, and testing is being done to determine whether the case in Ofu is due to the virus. Since July 2014, there have been 11 hospitalisations with the virus but no deaths.

Health officials continue to urge those with symptoms to drink plenty of fluids, get a lot of rest, and visit the emergency department if symptoms become serious.=======================[On 26 Jul 2014, it was reported that American Samoa had about 100 cases, with 3 laboratory confirmed as chikungunya virus infections (see ProMED-mail archive no. 20140727.2638925). This is a sharp outbreak, with over 700 cases in a little over one month. Once introduced into American Samoa, spread of the virus is not surprising, because it has had dengue virus transmission in the past, and the same mosquitoes that transmit dengue viruses can transmit chikungunya virus as well.

A HealthMap/ProMED-mail map showing the location of American Samoa in the Pacific Ocean can be accessed at

Reports on Chikungunya in American Samoa on Tutuila Island
Disease Chikungunya Virus American Samoa
- 6 years ago

The American Samoan Department of Health says there are now more than 300 confirmed cases of chikungunya or 'chik' virus in the territory.

The Health Director Motusa Tuileama Nua says his department and LBJ hospital have confirmed the outbreak of fever, rashes, and joint pains among people on the main island of Tutuila is due to chikungunya.

He says there have been 343 recorded cases, with 6 patients hospitalised and no deaths, since the beginning of July [2014].

He recommends those who are ill with fever and body aches do not travel off island.

The American Samoa Department of Health and the LBJ hospital have created a 24 hour a day hotline for the CHIK virus. The CHIK hotline number is 731-7511.

The Health Alert issued yesterday [7 Aug 2014] confirms chikungunya (CHIK) virus as the cause of fever, rash, and joint pains outbreak on Tutuila and there have been more than 390 recorded cases, with 7 patients hospitalized and no deaths since 1 Jul 2014.

According to the health alert, there is no cure for CHIK virus [infection, and] it can usually be treated at home by drinking lots of fluids, taking pain medicine like Tylenol, ibuprofen, or Aleve as needed but only as much and with cautions as recommended on the package.

The health alert urges not to work while your joints are painful, let them rest and apply ice or cold packs on the joints and this may protect against prolonged joint pain.

DOH notes you should go to the Emergency Room to see a doctor if symptoms persist more than 10 days, or if you have bleeding from any part of the body or bruised skin. Call the hotline "or come to the ER or clinic if you are worried about your condition getting worse."

The alert once again urges that people stay indoors in air-con, behind screens, or under bed nets while you are ill, because if you are bitten by mosquitoes while you are ill, you can spread the disease to your family and neighbors.

For travelers, the DOH urges those who are ill not to travel off island, including to Manu'a. "If you travel and become ill when you arrive, tell the doctor who sees you that you may have been exposed to the CHIK virus." [Byline: B. Chen]

[Interestingly, the 5 Aug 2014 report above indicated that there were 343 reported cases, and in the subsequent report of 8 Aug 2014 above, that number has increased to 390 cases, indicating that transmission of CHIK virus is continuing. - ProMed Mod.TY]

Samoa's Ministry of Health has reported 2 deaths from acute fever and rash, saying it is now an outbreak. A press statement from the Director General, Leausa Toleafoa Dr Take Naseri, says there have been 21 recorded cases as of earlier this week with 4 people hospitalised.

The cases are suspected to be chikungunya virus, similar to dengue fever, but results are yet to be confirmed and 3 children and one man have been admitted to the intensive care unit.

The ministry says collaboration with other government agencies, and media campaigns, aim to raise awareness of the outbreak and help its containment.

Samoa has also sought assistance from the Ministry of Health's development partners including the Secretariat of the Pacific Community and the World Health Organisation.

In neighbouring American Samoa, there have been more than 300 confirmed cases of chikungunya.======================[This is the 1st ever ProMED-mail report of a chikungunya outbreak in Samoa. Concerning the current outbreak, it would be unusual to have 2 deaths from chikungunya virus infections of a total of 21 recorded cases. One explanation for the high proportion of fatal cases could be significant underreporting of non-fatal cases. No mention is made indicating that there were contributory underlying medical conditions in these 2 fatal cases. ProMED-mail will be interested in receiving results of the laboratory tests when they become available.

Maps showing the location of Samoa in the Pacific Ocean can be accessed at

Health officials in American Samoa are warning the public about an amoebic dysentery outbreak which has so far affected 26 people, half of which have been admitted to the LBJ hospital. A Pacific Island Health Officers' Association Epidemiologist, Mark Duran, says the department of health is leading an investigation into the source of the parasite.

Dr Duran says amoebic dysentery is spread through contamination of human waste. "It especially attacks the intestines and invades its way into the wall of the intestines; it causes abdominal pain, it causes bloody diarrhoea, fever." Dr Duran says in serious cases the parasite can travel through the body and cause abscesses especially in the liver.===================[Maps of American Samoa can be seen at

Uzbekistan

Uzbekistan - US Consular Information SheetMay 07, 2007 COUNTRY DESCRIPTION:Uzbekistan gained independence from the Soviet Union in 1991.While the country has undergone significant change since then, its progress towards democratic
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nd economic reform has been halting and uneven.Corruption is endemic at all levels of society.Much of the country, particularly areas outside of Tashkent and the major tourist destinations of Samarkand, Bukhara, and Khiva, are remote and difficult to access.Tourist facilities, when they exist at all, are typically below Western standards, and many goods and services remain difficult to find on a regular basis.Read the Department of State Background Notes on Uzbekistan for additional information.

ENTRY/EXIT REQUIREMENTS:A passport and visa are required.Although official invitation letters are not required for American citizens applying for tourist visas, they are required for those planning to visit an individual who resides in Uzbekistan.Tourist visas cannot be extended in Uzbekistan.Visas are issued by Uzbek embassies and consulates abroad.Visitors coming from countries where Uzbekistan does not have diplomatic or consular representation should obtain visas in a third country.Visas are not available upon arrival at Uzbek airports.The Embassy has received a number of reports from American citizens who have had problems obtaining Uzbek visas or who received Uzbek visas valid for a very limited period, usually for fewer than three months.Americans seeking visas are encouraged to apply for their visas well in advance of their travel.

It is important to note that Uzbek visas indicate not only the validity of the visa, but also the period of time a person is allowed to stay in Uzbekistan on a given trip.A visitor will have to leave the country after the number of days indicated as the duration of stay on the visa.Therefore, it is important to indicate your intended period of stay when applying for your Uzbek visa.American citizens who are affiliated with a non-governmental organization (NGO), which has been closed in Uzbekistan, may be prevented from entering the country, even with a valid visa.All travelers, even those simply transiting Uzbekistan for fewer than 72 hours, must obtain an Uzbek visa before traveling to Uzbekistan.

The Uzbek Government maintains travel restrictions on large parts of the Surkhandarya province bordering Afghanistan, including the border city of Termez. The border crossing point at Hayraton between Afghanistan and Uzbekistan, while open, is tightly controlled.Foreign citizens intending to travel to this region must obtain a special permission card from the Ministry of Foreign Affairs, the Ministry of Internal Affairs or Uzbek embassies and consulates abroad.Even with such permission, however, some American citizens transiting to Afghanistan via Termez have been briefly detained and/or fined for not registering in Uzbekistan.

Travel within Uzbekistan by rail or land sometimes requires brief exit into neighboring countries.Travelers should have multiple-entry Uzbek visas and a proper visa for the neighboring country in order to avoid delays in travel.

Registration after entry:All travelers present in Uzbekistan for more than three business days must register with the Office of Entry, Exit, and Citizenship, commonly known as “OVIR.”Hotel guests are registered automatically, but all other travelers are responsible for registering themselves.Registration fees vary depending on length of stay.See http://uzbekistan.usembassy.gov/consular for more information.Visitors without proper registration are subject to fines, imprisonment, and deportation.The fines range from $500 to $4,000.Uzbek law mandates that visitors carry a medical certificate attesting that they are not infected with HIV, but this requirement is sporadically enforced.For more information, see the Department of State's Human Immunodeficiency Virus (HIV) Testing Requirements for Entry into Foreign Countries brochure.

Further visa information is available from the Consular Section of the Embassy of the Republic of Uzbekistan, 1746 Massachusetts Ave., NW, Washington, D.C. 20036; telephone: (202) 530-7291; fax: (202) 293-9633; website: http://www.uzbekistan.org ; or from the Consulate General of Uzbekistan in New York City, 866 United Nations Plaza, Suite 327A, New York, NY 10017; telephone:(212) 754-7403; fax: (212) 838-9812; website: http://www.uzbekconsulny.org .

See our Foreign Entry Requirements brochure for more information on Uzbekistan and other countries.Visit the Embassy of Uzbekistan web site at http://www.uzbekistan.org for the most current visa information.

See Entry and Exit Requirements for more information pertaining to dual nationality and the prevention of international child abduction .Please refer to our Customs Information to learn more about customs regulations.

SAFETY AND SECURITY:A Travel Warning remains in effect for Uzbekistan.The Department of State reminds U.S. citizens of the potential for terrorist attacks or civil disturbance in Uzbekistan, although there have been no violent incidents there since May 2005, and continues to urge Americans in Uzbekistan to exercise caution.The U.S. Government continues to receive information that indicates terrorist groups may be planning attacks, possibly against U.S. interests, in Uzbekistan.Supporters of terrorist groups such as the Islamic Movement of Uzbekistan, Al-Qaida, the Islamic Jihad Union, and the Eastern Turkistan Islamic Movement are active in the region.Members of these groups have expressed anti-U.S. sentiments and have attacked U.S. Government interests in the past, including the U.S. Embassy in Tashkent, and may attempt to target U.S. Government or private American interests in Uzbekistan.In the past, these groups have conducted kidnappings, assassinations, and suicide bombings.

Increased security at official U.S. facilities over the past year may lead terrorists and their sympathizers to seek softer targets.These may include facilities where Americans and other foreigners congregate or visit, such as residential areas, clubs, restaurants, places of worship, schools, hotels, outdoor recreation events, and resorts.The U.S. Embassy in Tashkent continues to employ heightened security precautions.U.S. citizens should report any unusual activity to local authorities and then inform the Embassy.

Uzbekistan experienced a wave of terrorist violence in 2004.In July 2004 there were three suicide bombings in Tashkent, including one outside the U.S. Embassy.The Islamic Jihad Union (IJU) claimed responsibility for the attacks.The IJU also used suicide bombers in multiple attacks focused on police and Uzbek private and commercial facilities in Tashkent and Bukhara in late March and early April 2004.In May 2005, armed militants stormed a prison in Andijon, released its prisoners, and then took control of the regional administration and other government buildings in Andijon Province.Fighting broke out between government forces and the militants, and reports indicated that several hundred civilians died in the ensuing violence.While there were no reports of U.S. citizens affected by these events, U.S. citizens and other foreigners in Uzbekistan frequently have experienced harassment from authorities and local residents since the 2005 violence.

Depending upon security conditions, travelers can expect restricted personal movement, including the closing of roads to traffic, and frequent document, vehicle, and personal identification checks should be anticipated.The Uzbek Government has intermittently restricted travel to certain parts of the country in response to security concerns.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s Internet website, where the current Travel Warnings and Public Announcements , including the Travel Warning for Uzbekistan , Worldwide Caution Public Announcement , and the Public Announcement for Central Asia, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada or, for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad .

CRIME:Uzbekistan’s rate of violent crime, including against foreigners, has increased in recent years.In urban areas, travelers are urged to take the same precautions against crime that they would take in a large American city.If you are traveling at night, please travel in groups, maintain a low profile, and do not display large amounts of cash.

Although using private cars as taxicabs is a common practice in Uzbekistan, Americans, especially women, should not consider this a safe practice.Americans are encouraged to use clearly marked taxicabs, such as those at hotels.Also, Americans should avoid riding in taxis alone.

In many countries around the world, counterfeit and pirated goods are widely available.Transactions involving such products may be illegal under local law.In addition, bringing them back to the United States may result in forfeitures and/or fines.More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm .

INFORMATION FOR VICTIMS OF CRIME:The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.If you are the victim of a crime while overseas, in addition to reporting the crime to local police, please contact the nearest U.S. Embassy or Consulate for assistance.The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:Medical care in Uzbekistan is below Western standards, with severe shortages of basic medical supplies, including disposable needles, anesthetics, and antibiotics.Elderly travelers and those with pre-existing health problems may be at particular risk due to inadequate medical facilities.Most resident Americans travel to North America or Western Europe for their medical needs.

Travelers are advised to drink only boiled water, peel all fruits and vegetables, and avoid undercooked meat.Due to inadequate sanitation conditions, travelers should avoid eating unpasteurized dairy products and most food sold in the streets.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s internet site at http://www.cdc.gov/travel .For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) website at http://www.who.int/en .Further health information for travelers is available at http://www.who.int/ith .

MEDICAL INSURANCE:The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.The information below concerning Uzbekistan is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Uzbekistan has a developed but deteriorating traffic infrastructure.Although main roads in central Tashkent are relatively well maintained, many secondary roads inside and outside Tashkent, and particularly those in the Tien Shan and Fan Mountains, are in poor condition and may be passable only by four-wheel-drive vehicles.Driving at night can be quite dangerous because only the main roads in Tashkent and a few other major cities have streetlights; rural roads and highways generally are not lit.Visitors are strongly urged to avoid driving at night outside Tashkent.The gasoline supply can be sporadic; therefore, travelers should expect occasional difficulty finding gasoline, particularly outside of Tashkent.

Livestock, as well as farm equipment and carts drawn by animals that lack lights or reflectors, are found on both urban and rural roads at any hour.Local drivers are not familiar with safe driving techniques.Pedestrians in cities and rural areas cross streets unexpectedly and often without looking for oncoming traffic.Uzbekistan has a large road police force, which frequently stops drivers for minor infractions or simple document checks.There have been reports of harassment of foreign drivers by the road police, with reported minor police corruption in the form of solicitation of bribes.

Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:The U.S. Federal Aviation Administration (FAA) has assessed the Government of Uzbekistan’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Uzbekistan’s air carrier operations.For more information, travelers may visit the FAA’s Internet web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa .

SPECIAL CIRCUMSTANCES: Travelers to Uzbekistan are subject to frequent document inspections.Therefore, U.S. citizens are strongly encouraged to carry a certified copy of their U.S. passport and their Uzbek visa with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship are readily available.In accordance with the Vienna Convention on Consular Relations and certain bilateral agreements, local authorities must grant a United States Consular Officer access to any U.S. citizen who is arrested.U.S. citizens who are arrested or detained should ask to contact the U.S. Embassy immediately.

Uzbek customs authorities may enforce strict regulations concerning temporary import to or export from Uzbekistan of items such as armaments and ammunition, space technology, encryption devices, X-ray and isotope equipment, nuclear materials, poisons, drugs, precious and semi-precious metals, nullified securities, pieces of art, and antiques of historical value.Contact the Embassy of Uzbekistan in Washington, D.C. or the Consulate of Uzbekistan in New York for specific information regarding customs requirements.

Most transactions are conducted on a cash-only, local currency (soum) basis.Credit cards are accepted only at the main hotels and a few shops and restaurants; travelers’ checks can be cashed into dollars at the National Bank of Uzbekistan.The commission fee is two percent.Importation of currency exceeding $10,000 (US) is subject to a one- percent duty.Foreigners must complete a customs declaration upon entering Uzbekistan and may face fines upon departure if unable to produce certificates verifying legal conversion of foreign currency.Old U.S. dollar bills (prior to 1990) and/or those in poor condition (with tears, writing or stamps) are not acceptable forms of currency in Uzbekistan.Although payment in U.S. dollars is required for certain hotel charges, airline tickets, and visa fees, other dollar transactions, as well as black market currency exchanges, are prohibited.Please see our Customs Information.

Uzbekistan is an earthquake-prone country.General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/ .

CRIMINAL PENALTIES:While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.Penalties for breaking the law can be more severe than in the United States for similar offenses.Persons violating Uzbek laws, even unknowingly, may be expelled, arrested or imprisoned.Penalties for possession, use, or trafficking in illegal drugs in Uzbekistan are severe, and convicted offenders can expect long jail sentences and heavy fines.Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues website.

REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Uzbekistan are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website and to obtain updated information on travel and security within Uzbekistan.Americans without Internet access may register directly with the U.S. Embassy in Tashkent.By registering, American citizens make it easier for the Embassy to contact them in case of emergency.The U.S. Embassy is located at # 3, Moyqorghon Street, 5th Block, Yunusobod District, Tashkent -700093, Uzbekistan.The main Embassy telephone number, which can also be reached after hours, is (998 71) 120-5450, fax:(998 71) 120-6335; Consular fax: (998 71) 120-54-48; e-mail address: ConsularTashkent@state.gov; web site: http://uzbekistan.usembassy.gov.*

*

*This replaces the Consular Information Sheet dated October 13, 2006, to update the sections on Country Description, Entry/Exit Requirements, Safety and Security, Crime, and Traffic Safety and Road Conditions.

Tashkent, May 3, 2020 (AFP) - Uzbek authorities on Sunday launched a criminal probe after a major dam burst, prompting the evacuation of tens of thousands of people from flooded homes there and in Kazakhstan. The wall of the Sardoba reservoir dam in eastern Uzbekistan burst early on Friday and at least 70,000 people have been evacuated. More than 50 people were hospitalised. Over 600 homes in southern Kazakhstan have also been flooded.

Uzbekistan's state prosecutor said on Sunday that a criminal case had been opened into "official negligence" and construction violations. Construction of the Sardoba dam began in 2010 under the supervision of current President Shavkat Mirziyoyev, who was prime minister at the time. It was completed in 2017. Mirziyoyev on Friday flew to the region, which saw strong winds and rains prior to the collapse of the dam, in order to oversee the evacuation and cleanup operation.

Officials in Kazakhstan's southern Turkestan region, where more than 5,000 people have been evacuated so far, criticised Uzbekistan for not providing timely information on the status of flood control Saturday. "We have a copy of our correspondence with the Uzbek side, that as of (8 pm on Friday) the situation was stable and there were no problems," said Saken Kalkamanov, deputy governor of the Turkestan region. "They said that not a drop of water would reach Maktaraal district," he said, referring to the area where the flood hit. "Nevertheless, what happened has happened." The administration of the Turkestan region estimated that the floods caused crop damage worth more than $400,000 -- mostly to the cotton, which is grown throughout the Central Asian region.

Tashkent, Feb 1, 2019 (AFP) - Uzbekistan on Friday granted visa-free entry to citizens of 45 countries to boost tourism, which the government views as vital for economic growth. The countries benefiting from a 30-day visa waiver that went into force on Friday include the majority of European countries including Britain as well as Australia, Canada, Argentina and Chile. The United States is a notable exception.

The impoverished ex-Soviet country has made tourism a priority to reduce its dependence on commodity exports. The government is keen to show off the lavish Silk Road heritage of ancient cities such as Bukhara, Khiva and Samarkand. Earlier this year, Uzbekistan granted a 30-day visa waiver to Germany while France became the first European Union country to benefit from the measure last year.

Uzbekistan's tourism committee said last month that annual visitor numbers for 2018 were 5.3 million, double the figure for 2017. President Shavkat Mirziyoyev has reversed a number of policies that hampered tourism under his late predecessor Islam Karimov. Among the restrictions he scrapped was a ban on photography in the capital Tashkent's ornate metro that had led to police detentions of unsuspecting tourists. Mirziyoyev's bid to boost tourism in the immediate aftermath of Karimov's death in 2016 suffered a false start.

In December that year, he issued an order easing or cancelling visa requirements for visitors from 27 developed countries but this was swiftly reversed before coming into force. Observers attributed the reversal to resistance within the powerful security apparatus. Uzbekistan already offers visa-free entry to visitors from Turkey, Israel, Indonesia, South Korea, Malaysia, Singapore and Japan, in addition to long-standing reciprocal visa-free entry for citizens of most former Soviet countries.

Tashkent, Jan 4, 2019 (AFP) - Uzbekistan said Friday it will allow German citizens to visit for up to 30 days visa-free to boost tourism as the ex-Soviet country emerges from long-term isolation. Germany will be the second European Union country after France to gain visa-free travel to Uzbekistan, which has opened up somewhat since the death of its long-reigning hardline leader Islam Karimov in 2016. Germans will be able to enter the central Asian nation visa-free from January 15, the Uzbek tourism committee said Friday, three months after authorities granted French citizens the same 30-day visa waiver.

The impoverished country is highly dependent on commodity exports and has made developing tourism a priority. In particular the government is keen to show off the lavish Silk Road heritage of cities such as Bukhara, Khiva and Samarkand. According to the Uzbek tourism committee, 18,094 Germans visited Uzbekistan in 2018, almost five times as many as in 2016. Reform-touting Uzbek president Shavkat Mirziyoyev is set to visit Germany this month after meeting US President Donald Trump and French leader Emmanuel Macron last year. These high-profile visits are seen as rewards for his steps towards greater openness following the death of Karimov, under whom Mirziyoyev served as prime minister for 13 years. The current president has reversed a number of policies that hampered the tourism sector in recent years.

Among the restrictions he scrapped was a ban on photography in the capital Tashkent's ornate metro that had led to police detentions of unsuspecting tourists. Mirziyoyev's bid to boost tourism in the immediate aftermath of Karimov's death suffered a false start, however. In December 2016, he issued an order easing or cancelling visa requirements for visitors from 27 developed countries but this was reversed a month later before actually coming into force. The reversal was attributed to resistance within the powerful security apparatus. Uzbekistan offers visa-free entry to citizens of Turkey, Israel, Indonesia, South Korea, Malaysia, Singapore, and Japan, in addition to long-standing reciprocal visa-free entry for citizens of most former Soviet countries.

WHO declares Uzbekistan to be Malaria-free
Disease Malaria Uzbekistan
- 1 year ago

The World Health Organization (WHO) has certified Uzbekistan as malaria-free, confirming the end of the country's half-century-long battle for malaria elimination within its borders. Uzbekistan has become the 2nd country in 2018 to be certified malaria-free -- Paraguay was certified in June -- marking another milestone on the road to ending the disease for good.

"Malaria No More commends the government of Uzbekistan for its resilience and determination to eliminate malaria once and for all. Uzbekistan's decade-long commitment demonstrates the government's recognition that malaria stood in the way of development, and that ridding the country of the disease was critical to improving [the country's] economic outlook and protecting the health of its people," said Martin Edlund, CEO of Malaria No More.

Uzbekistan 1st eliminated malaria in 1961 but struggled to maintain elimination as malaria cases continued to flow in from neighbouring countries. In 2000, recognising the barriers that having malaria within its borders had on the country's economy and overall health of its citizens, the government of Uzbekistan stepped up its investment and implemented a holistic multisectoral approach that went beyond health, with support from other ministries -- agriculture, education and transportation.

Highlighting the critical factors needed to get the job done, the WHO certification committee cited Uzbekistan's decision to maintain its support of the nation's primary health care system -- the backbone of the malaria response -- even during the economic crisis that gripped the country during the 1990s; its use of data to better target malaria interventions where they're need most; and its approach toward early detection, diagnosis and efficacious treatment of malaria patients -- free of charge and irrespective of nationality.

Another critical factor was support from non-governmental organizations and partners, particularly the Global Fund to Fight AIDS, TB and Malaria, which played a vital role in Uzbekistan's achievement by providing financial support to ensure the national malaria program had the full amount of insecticide-treated bed nets, indoor residual spraying equipment, medicines and other tools needed to protect its citizens from malaria. [Byline: Sola Ogundipe]

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[ProMED congratulates Uzbekistan with this important achievement. It is important to note that the achievement included mobilization beyond the health sector alone, applying a "holistic multisectoral approach that went beyond health," and the importance of the "primary health care system -- the backbone of the malaria response."

It is also noted that the malaria-free status would probably not have been achieved without the support of "non-governmental organizations and partners, particularly the Global Fund to Fight AIDS, TB and Malaria." - ProMED Mod.EP]

Samarkand, Uzbekistan, April 29, 2018 (AFP) - Coiffed, cheerful and multilingual, identical twins Fatima and Zukhra Rakhmatova do not immediately resemble agents of ex-Soviet Uzbekistan's long-feared security apparatus. But the photogenic 30-year-old pair are frontline members of a newly formed, user-friendly Tourist Police deployed in the famed Silk Road city of Samarkand and other hotspots as a visitor boom sweeps the Central Asian country.

The force, established in January, is viewed as part of a broader opening initiated by Uzbekistan's authoritarian government following a long period of self-enforced isolation. More than 2.5 million tourists visited Uzbekistan last year, a 24 percent increase on the previous year, according to the UzDaily news site. "In the past I worked as a teacher and then as a wedding stylist. I even won a national prize as a stylist," recalls Zukhra Rakhmatova, one half of a sister act proficient in English, Russian, Farsi, Turkish and Japanese. "But our grandfather served in the force and our uncle too," Rakhmatova told AFP. "It was always our dream to serve."

- Change and continuity - Samarkand -- a former power centre positioned at the epicentre of millennia-old trade routes linking China and Europe -- hosts symbols of authoritarian continuity as well as tentative reform. A short walk from the ceramic and marble dazzle of the three madrasahs towering over the city's old square is the statue of Islam Karimov, who ruled the country from before independence in 1991 until his death in 2016. Laid to rest in a grand mausoleum in Samarkand's historic centre, Karimov is criticised by rights groups as the architect of one of the world's most repressive and closed-off police states.

Far from being disavowed, his monument is now yet another photo opportunity for visitors and wedding parties in the city, where he was born in 1938 and remains widely revered. "Everyone makes mistakes but Islam Karimov is a hero. He worked day and night to protect the Uzbek people," said a 22-year-old bridesmaid posing for pictures by the monument. The young woman, who did not give her name but said she had travelled to Samarkand from the capital Tashkent, refused to say what "mistakes" she thought Karimov had made.

- Power struggle -Whether out of political pragmatism or genuine deference to a man he served for 13 years as prime minister, Karimov's successor, 60-year-old Shavkat Mirziyoyev has also continued to honour his mentor in public. In the aftermath of the former leader's death, new strongman Mirziyoyev likened him to a "father", even as he toned down some of the totalitarian excesses that defined Karimov's 27-year rule.

Foreign tourism, which grew by around a quarter during Mirziyoyev's first year in office emerged as a key battleground in a power struggle that pitted the new reform-touting president against regime hardliners. In February for instance, Mirziyoyev ordered the introduction of a 30-day visa-free regime for citizens of seven countries -- Israel, Indonesia, South Korea, Malaysia, Singapore, Turkey and Japan -- and relaxation of registration rules for citizens of 39 others.

In cities like Samarkand, the changes were cheered by a population that endured long stretches of economic stagnation under Karimov. "(We need to) open up of course!" said Malika Shakhimardonova, a chef at a mutton-grilling teahouse in the shadows of the Bibi-Khanym Mosque, completed on the orders of medieval conqueror Tamerlane in the 15th century. "Let the tourists arrive to us like brothers and sisters!" said Shakhimardonova, whose kitchen is expanding.

- 'Take photos and share them!' -Many saw significance in the fact that Mirziyoyev's relaxation of visa restrictions came days after Rustam Inoyatov, 73, who led the notorious national security service for over two decades, was dismissed. Inoyatov was widely reported to have blocked a previous effort by Mirziyoyev to revamp tourism and to have insisted on retaining long-standing security measures, including a blanket ban on photography in the capital's metro. Such bans, which occasionally saw visitors detained by police, were "rudiments of the Soviet Union" now consigned to the past, said the country's new 44-year-old tourism chief Aziz Abdukhakimov.

"We want tourists to take as many photos as possible. Put them on Instagram! It is the best advert for the country," he told AFP. The Rakhmatova sisters, who scoot around Samarkand on two-wheeled, motorised "Segways" and are trained to administer first aid, certainly seem far removed from the grimmer elements of a former communist police state. But Fatima jokes their dual presence on the tourism beat might sometimes give visitors a different impression. "Some tourists will see one of us close to one attraction then move on to another and find the other sister standing there," she explained. "They smile but sometimes give us a strange look. Probably because we are identical they think the police are following them around," she laughed.

World Travel News Headlines

Nicosia, June 6, 2020 (AFP) - Cyprus opens back up for international tourism on Tuesday, with airports welcoming visitors after an almost three-month shutdown, and a bold plan to cover health care costs for visitors. But with arrivals expected to be down by 70 percent this year due to the chaos brought by the COVID-19 pandemic, it's a leap of faith for the small Mediterranean holiday island. "Nobody here is expecting to make any money this year", Deputy Tourism Minister Savvas Perdios told AFP. "We are setting the stage for the beginning of our recovery in 2021."

The divided island's tourism sector normally accounts for around 15 percent of GDP but has dried up in past months amid global measures to combat the spread of the novel coronavirus. Cyprus saw a record 3.97 million arrivals in 2019, with more than half its market made up of British and Russian visitors. But even if the island's airports in Larnaca and Paphos will open up to arrivals on Tuesday with the first flight due to arrive from Athens around midday (0900GMT), neither Britain or Russia are among the 19 countries allowed to land there.

The list of permitted countries, which also include Bulgaria, Germany and Malta, have been chosen based on epidemiological data and split into two categories. Initially all travellers will need to show proof of a negative COVID-19 test undertaken within 72 hours of travel, but from June 20, only those arriving from six countries in the second category, such as Poland and Romania, will need to do so. The government says the lists will be revised weekly and more countries can be added.

Cyprus will also cover accommodation, dining and medical care for any tourists who fall ill with the COVID-19 illness during their stay, as well as accommodation and meals for their families and close contacts. "What we offer and what we sell is not the sun and the sea, it's hospitality, and this is an extension of our hospitality," Perdios said. The government has designated a 100-bed COVID-19 hospital for tourists that Perdios said would be located in the Larnaca region, while 112 ICU units have been allocated for visitors. Perdios said several four-star hotels would provide 500 quarantine rooms for close contacts of those who fall ill.

- 'Right thing to do' -A raft of other health measures, including disinfection protocols and temperature checks at border controls, aim to protect travellers and locals alike. "We've gone to big lengths to think ahead of things that could go wrong and try to devise plan Bs and Cs", Perdios said. The Republic of Cyprus, in the south of the island, has registered 960 novel coronavirus cases and 17 deaths. Perdios expressed hope that British tourists could be welcomed "sometime after mid-July", with Russia "slightly later, maybe by a couple of weeks".

A recently announced deal with Hungarian low-cost carrier Wizz Air to open a base in Cyprus from July was also an important step towards expanding and diversifying the island's tourist markets, he said. While no date has been set to allow international tourists to visit the breakaway Turkish Republic of Northern Cyprus, only recognised by Ankara, the health care commitment would still apply to those visiting the north during their stay once the crossings are reopened. "I am very confident that not only will we be able to continue providing our citizens with protection, but also caring for everybody who comes to the island on holiday", he said. "If we are coming out with a scheme like this, it's because we can afford it, but most importantly, because we feel that it's the right thing to do."

Orlando, June 5, 2020 (AFP) - Tourists donned masks Friday and visited the attractions at Universal Orlando, the first of the major theme parks in Florida to open since the COVID-19 pandemic shut them down almost three months ago. Universal Orlando resort and the other theme parks in this central Florida city closed on March 15 to prevent the spread of coronavirus. New back-to-fun rules at the park include temperature controls at the entrance, mandatory use of face masks, markers on the ground to help enforce social distancing and posters thanking the public for their help "during this unprecedented time."

Universal Orlando is only reopening at 35 percent capacity and has launched a system of virtual lines in which space can be reserved, to avoid queues and crowds. Terrence Wilson, 19, was happy with the result. "There's not a lot of people. I can get on all the rides without having to wait 40 minutes or an hour" he told the Orlando Sentinel.

On Monday, the Legoland Florida park opened in the city of Winter Haven, while SeaWorld in Orlando is scheduled to open on June 10. The largest of Orlando's parks, Walt Disney World, will open on July 11. That day the park's Magic Kingdom and Animal Kingdom sections will begin operating, while EPCOT and Hollywood Studios will follow suit on July 15. Orlando is home to most of the state's theme parks and every year welcomes millions of tourists from all over the world.

Riyadh, June 5, 2020 (AFP) - Saudi Arabia on Friday announced a renewed lockdown in the city of Jeddah, gateway to the annual Muslim pilgrimage to Mecca, to counter a new spike in coronavirus cases. "After reviewing the epidemiological situation and the high occupancy rates of intensive care departments, it was decided to take strict health precautions in the city of Jeddah for two weeks," starting from Saturday, the health ministry said. The measures include a curfew running from 3 pm to 6 am, a suspension of prayers in mosques and a stay-at-home order for public and private sector workers in the Red Sea city whose airport serves Mecca pilgrims.

After an easing of precautions in the kingdom in late May, the ministry said that strict measures could also soon return to Riyadh, which was "witnessing a continuous increase during the last days" of critical cases of the pandemic. Saudi Arabia has declared almost 96,000 coronavirus infections and 642 deaths from the Covid-19 respiratory disease, the heaviest toll in the Gulf. It has suspended the year-round "umrah" pilgrimage to Mecca and Medina over fears of the coronavirus pandemic spreading to Islam's holiest cities.

Authorities are yet to announce whether they will proceed with this year's hajj, scheduled for the end of July, but have urged Muslims to temporarily defer preparations for the annual pilgrimage. Last year, some 2.5 million faithful travelled to Saudi Arabia from across the world to take part in the hajj, which all Muslims must perform at least once in their lives if able.

Dublin, June 5, 2020 (AFP) - Ireland will dramatically accelerate its plan to ease coronavirus lockdown restrictions in the coming days, Prime Minister Leo Varadkar said Friday. "Today I can confirm that it is safe to move to phase two of the plan to reopen our country starting on Monday," Varadkar told a press conference. "I'm also announcing an acceleration of the roadmap." More workplaces will open and household visits will be permitted from Monday in line with the government plan to reopen the Republic announced in May.

However an escalation of the scheme will see citizens allowed to travel across their county of residence and/or up to 20 kilometres (12 miles) from home. All shops will also be permitted to reopen whilst the final stage of the "roadmap" to end lockdown -- in place since 28 March -- will be brought forward from August to July. Playgrounds will reopen while the government now intends to allow hotels, restaurants and bars serving food to resume trade on June 29. "We are making progress, we are heading in the right direction, and we have earned the right to be hopeful about the future again," Varadkar said. Ireland has suffered 1,664 deaths from the coronavirus, according to official figures. Recorded deaths peaked at 77 in a single day in April, but by Thursday that figure had fallen to just five.

The Republic last Monday registered its first day without any COVID-19 deaths in more than two months, one week after entering the first phase of its plan to leave lockdown. "We've proved we can suppress the virus, but now we do face another test," said health minister Simon Harris. "We must prove we can live alongside it and keep it weak at the same time."

The easing includes provisions for shops to hold staggered opening hours and social distancing measures to remain in place. "We must remain careful, cautious vigilant, and together," Harris added. Finance minister Paschal Donohoe announced Friday that a government wage subsidy scheme enacted when the nation entered lockdown will be extended until the end of August. To date, 1.37 billion ($1.55 billion) euros has been paid to half a million employees. But he warned "this support cannot last forever" and he expected to see a continued decline in reliance on the scheme.

Quito, June 5, 2020 (AFP) - As much of Ecuador went into lockdown against the coronavirus, scientists shipped out of the Galapagos, leaving important research activity frozen and the Pacific archipelago's tourism in deep crisis. Authorities are desperately hoping for a revival of the vital tourism industry -- the main engine of the local economy -- once visitors are allowed to fly in again from July 1.

In the meantime, local officials say they have to take a leaf out of English naturalist Charles Darwin's book and "adapt to survive." Darwin based his theory of evolution on his studies of the islands' unique flora and fauna. But dozens of researchers following in his footsteps had to leave before air links were shut down as the pandemic advanced. "Science has to a large extent been paralyzed these days in the Galapagos," Diego Quiroga of Quito's San Francisco University told AFP.

Sixteen researchers of various nationalities from the university's Galapagos Science Center were repatriated along with 50 US students when Ecuador shut its borders, suspended flights and imposed strict restrictions on movement in mid-March. The move meant that the Galapagos was largely spared the devastating impact of the virus felt on the mainland. Ecuador, a country of 17 million, has more than 40,000 infections with 3,500 deaths. The Galapagos is the least affected of its provinces, with fewer than 80 infections among its 30,000 population.

- Research suspended -The 76 projects being carried out under the Center's auspices remain in limbo, and an international congress set to draw 200 scientists to the archipelago was canceled. The Charles Darwin Foundation, which has been operating on the islands for 60 years, had to shelve 20 research programs.

Around 30 of its scientists and volunteers who were carrying out field work "had to abandon their investigation sites," said Maria Jose Barragan, the foundation's CEO and science director. With them went "an important season of investigation into the reproductive cycle of birds" in the Galapagos, she said. The Galapagos National Park (PNG), a public body responsible for conservation of the archipelago, continues to operate.

- Adapting to less -The Charles Darwin Foundation fears, however, the long-term impact of the pandemic on future research. "I think the global picture for the conservation sector, regarding acquisition and availability of funds, will change becaus there will likely

be other interests" competing for funds, said Barragan. "We have to adapt, which is actually the principle of the theory of evolution: change and adapt," she said.

Galapagos Science Center head Carlos Mena says he does not believe "funding for science is decreasing, but yes, it will move to other sectors, such as economic rejuvenation or the study of diseases and viruses." As things stand, any freeze in research projects affects livelihoods on the archipelago. Mena says this will translate into almost a million dollars in lost revenue for 2020. "Science brings in revenue. It's not huge, not like tourism, but yes, it generates revenue."

In the months of lockdown, between March and May, the Galapagos -- which had more than 270,000 visitors last year -- lost $200 million in tourism revenue, according to the Provincial Chamber of Tourism. "The revenue is zero. There have been no tourists, therefore no admissions to the park, nor the economic revenue" they generate, said park director Andres Ordonez.

Mena believes tourism will come back stronger after the coronavirus, saying the work of researchers can "serve as a guide for better tourism" in the islands with their fragile ecosystems. "The Galapagos have always been considered as a laboratory for studying the evolution of species," he said. "We can also see them as a laboratory for building tourism or a better model of society than before the pandemic."

Rio de Janeiro, June 5, 2020 (AFP) - Brazil's death toll from the novel coronavirus has surged to become the third-highest in the world, surpassing Italy's, according to official figures released Thursday. The South American country of 210 million people reported a new record of 1,473 deaths in 24 hours, bringing its overall toll to 34,021, from 614,941 infections, the health ministry said. Italy has confirmed 33,689 deaths from 234,013 infections.

Johannesburg, June 4, 2020 (AFP) - South Africa said Thursday it had recorded 3,267 novel coronavirus cases in 24 hours, the biggest jump since the pandemic hit the country. Africa's biggest industrial power now has a total of 40,792 infections, the health ministry said. It saw a rise of 56 deaths for a total of 848 fatalities. More than half of the cases are in the Western Cape region where health services are under pressure.

South Africa is the sub-Saharan African country hardest hit by the pandemic. President Cyril Ramaphosa on March 27 ordered South Africans to observe a lockdown aimed at slowing the disease's spread. The move sharply limited people's freedom of movement while slowing an economy already in recession. But Ramaphosa has gradually eased the lockdown measures and allowed most of the economy to restart.

Masks to be compulsory on public transport in England (from the 15th June!)
Disease SARS United Kingdom
- 23 hours ago

Date: Thu, 4 Jun 2020 18:41:36 +0200 (METDST)

London, June 4, 2020 (AFP) - Masks will be compulsory on public transport in England from next week to prevent the spread of the coronavirus, transport minister Grant Shapps said Thursday. "As of 15th June, face coverings will be mandatory on public transport," he said at a daily briefing on the government's response to the coronavirus outbreak. The government had previously advised people to wear face coverings in enclosed spaces such as shops and public transport but stopped short of making them compulsory. They remain only a recommendation in Scotland, Wales and Northern Ireland, whose devolved administrations have responsibility for transport.

The announcement was made as part of plans to ease lockdown restrictions in England, as infection rates and the number of deaths from COVID-19 falls. A total of 39,904 people have died in the outbreak in Britain, according to the latest official figures, which is the second-highest toll in the world after the United States. "We need to ensure every precaution is taken on buses, trains, aircraft and on ferries," said Shapps, calling the use of face coverings a "condition of travel". Small children, the disabled and anyone with breathing difficulties would be exempt, he added. "We expect the vast majority won't need to be forced into this," he said, but warned that anyone refusing to do so could be prevented from travelling or even fined.

Cox's Bazar, Bangladesh, June 4, 2020 (AFP) - Rohingya refugees infected with coronavirus are fleeing quarantine in their Bangladesh camps because they fear being transferred to an isolated island in the Bay of Bengal, community leaders said Thursday. At least two infected refugees have gone missing since testing positive for the virus after the first COVID-19 death was reported Tuesday, they said.

About one million Rohingya -- most of whom fled a military crackdown in Myanmar in 2017 -- are packed into camps along the Bangladesh border, and the coronavirus has become the latest cause of misery. Aid agencies have long warned that the virus could cause chaos in the overcrowded camps, where social distancing is virtually impossible. So far only 29 infections have been detected, although 16,000 Rohingya are in quarantine zones within the camps.

It was not immediately clear how many tests have been conducted in the camps, but a senior health official said two people who proved positive had "fled the isolation hospital". He added that only 20 refugees agreed to be tested in the past two days because they believe those infected will be sent to Bhashan Char island in the Bay of Bengal. "It has created mass panic," Nurul Islam, a community leader, told AFP.

Bangladesh authorities have long wanted to establish a camp for 100,000 people on the isolated island, and have already sent 306 Rohingya there. "The Rohingya are petrified," the health official told AFP on condition of anonymity. "We have told them they won't be sent anywhere."

Some 500 isolation beds have been prepared in the camps, but most are empty because so few confirmed cases have been found, according to the official. The first Rohingya fatality from the coronavirus was announced only Tuesday, and health officials say they desperately need to increase testing to see how widespread the virus may be. But Khalilur Rahman Khan, the government administrator of one camp block, said doctors told him refugees were reluctant to participate.

Several Rohingya leaders said the transfer of the 306 refugees to Bhashan Char had sparked rumours that anyone with coronavirus would be sent to join them. "People are scared to go for virus tests," said Abu Zaman, a community leader. Mohammad Shafi, a camp neighbour of the refugee whose death was announced Tuesday, said people who had coronavirus symptoms such as fever and aches insisted they only had seasonal flu. "I tried to reassure them that this a curable disease and most people will recover, but many don't believe it," he said.

Santiago, June 3, 2020 (AFP) - Chile's government said Wednesday it was prolonging a three-week shutdown of the country's capital Santiago as the COVID-19 death toll reached a new daily record. Health officials said 87 people had died in the previous 24 hours, and nearly 5,000 new infections were recorded. The South American copper-exporting nation has now registered more than 113,000 infections and 1,275 deaths.

Health Minister Jaime Manalich confirmed the government was extending a three-week lockdown of the capital for another week. The city is home to seven million of the country's 18 million population and produces half its GDP. Manalich said the population's mobility had only been reduced by 30 percent, because of a large numbers of permits granted to those needed for essential activities. "There are many permits," the minister said, warning that "for the quarantine to be effective, mobility needs to be reduced by at least 50 percent."

The minister appealed to people to minimize time spent outside of their homes to help reduce infections, especially in the coming weeks when emergency health services are expected to be operating at maximum capacity. Already in Santiago, 97 percent of intensive care unit beds are occupied, while units in the rest of Chile report having reached 88 percent capacity.